P Wave Dispersion and Left Atrial Appendage Function for Predicting Recurrence after Conversion of Atrial Fibrillation and Relation of P Wave Dispersion to Appendage Function

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Abstract
We investigated P wave dispersion and left atrial appendage (LAA) function for predicting atrial fibrillation (AF) relapse, and the relationship between P wave dispersion and LAA function.Sixty-four consecutive patients with AF lasting /=5 days, LA size >/=45 mm, maximum P wave duration >/=112 ms, P wave dispersion >/=47 ms, spontaneous echo contrast, minimum LAA area >/=166 mm(2), and LAA emptying velocity <36 cm/sec were univariate predictors of recurrence (each P < 0.05). By multivariate analysis, LA size (P = 0.02), P wave dispersion (P < 0.001), and LAA emptying flow (P = 0.01) identified patients with recurrent AF. Their positive predictive values were 91, 97, and 72%, respectively.The increased P wave dispersion in addition to the dilated LA and the depressed LAA emptying flow can identify patients at risk of recurrent AF after cardioversion.

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