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PAROKSİSMAL ATRİYAL FİBRİLASYONLU HASTALARDA SOL ATRİUM BOYUT VE FONKSİYONLARININ P DALGA DİSPERSİYONU ÜZERİNE ETKİSİ

Journal Name:

  • İstanbul Tıp Fakültesi Dergisi

Publication Year:

  • 1999

Key Words:

Keywords (Original Language):

Author NameUniversity of AuthorFaculty of Author
Abstract (2. Language): 
The effect of left alrial dimension and funetion on P wave dispersion in patient with pa-roxysmal atrialfibrillation. Paroxysmal atrial fibrillation (PAF) seems to be caused by the in-homogenous and fractionated dispersal of sinüs node İmpulsc. It was reported that P wave du-ration in normal subjects can be influenced by changes in the atrial size. The purpose of this study was to compare the effect of atrial dimensİons and funetion on P wave dispersion in normal persons and non-seleeted PAF patients. The study group consİsted of 60 consecutive non-selected patients with PAF (M:F 31:29, mean age 55+10 years) and 33 age and sex matehed (M: F 18:15, mean age 54±10 years) controls. On echocardiographic examination left atrial (LA) dimensions, volumes and atrial ejection fractİon (EF) were calculated. The difference between the maximum and minumura P wave duraîion İn 12-lead eleetrocardiography was laken as the P wave dispersion. The PAF patients with normal LA dimensions had longer P wa-ve dispersion compared to controls (53±8 ms vs 35±9 ms, p<0.0001). The P wave dispersion was longer in PAF patients with inereased LA dimensions (62+12 ms vs 53+8, p=0.02), the inerease correlated to LA diameter, volume and atrial EF (r=0.39, p=0.006, r=0.60, p-0.001, r=-0.43, p-0.01, respectively). It was coneluded that in PAF patients, due to changes in left atrial clectrophysiologic properti-es, P wave dispersion was inereased compared to controls. Increased LA dimensions and dec-reased atrial EF caused further prolongation in P wave dispersion was inereased compared to controls.
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Abstract (Original Language): 
Paroksismal atriyal fibrilasyon (PAF), sinüs uyarılarının homojen olmayan vc kesintili yayılması sonucu oluşmaktadır. Normal kişilerde, P dalga süresinin atriyal hacimdeki değişikliklerden etkilendiği bildirilmiştir. Çalışmamızın amacı, sol atriyum (LA) boyut ve fonksiyonlarının normallerde ve seçilmemiş PAF hasta grubunda, P dalga dispersiyonu üzerine etkisini araştırmaktadır. Altmış ardışık PAFlı hasta (E/K:31/29, ort yaş 55±10) ve 33 yaş ve cinsiyet olarak benzer kontrol grubu (E/K: 18/15, ort yaş 54+10) çalışmaya alındı. Ekokardiyografik olarak LA çapları, volümleri ile atriyal cjeksiyon fraksiyonu (EF) hesaplandı. On iki derivasyonlu EKG'de maksimum ve minimum P dalga süreleri arasındaki fark, P dalga dispersiyonu olarak tanımlandı. Sol atriyum büyümesi olmayan PAF'lı hastalarda, P dalga dispersiyonu kontrole göre artmış bulundu (53±8 ms'ye karşı 35±9ms, p<0.0001). Sol atriyumu normalden büyük, PAF olan hastalarda dispersiyonun daha fazla arttığı ve bu artışın LA çap, volüm, atriyal EF ile korele olduğu tespit edildi (62±12ms'e karşı 53±8ms, p=0.02; LA diastolik çapı r=0.39; p=0.006; LA di-yastolik volümü r=0.60, p=0.001, ve atriyal EF r=-0.43, p=0.01). Sonuç olarak paroksismal atriyal fıbrflasyonu (PAF) olan hastalarda atriyumun kendine özgü elektrofizyolojik özellikleri nedeni ile P dalga dispersiyonu kontrole göre artmaktadır. Büyük ve fonksiyonu azalmış sol atriyumu olan PAF' lı hastalarda ise bu dispersiyon daha da artmaktadır.
FULL TEXT (PDF): 
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  • 4
379-383
  • Turkish

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