P Wave Peak Time on Surface ECG Predicts Post-Operative Atrial Fibrillation

Researchers, led by Ahmet Zengin, MD, from the Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center in Üsküdar/Istanbul, Turkey, evaluated a newly developed electrocardiography (ECG) parameter, P wave peak time (PWPT), as a predictor for post-operative atrial fibrillation (AFib) in patients undergoing cardiac surgery. Their study, published in the Irish Journal of Medical Science, reported that “PWPT in leads DII and V1 can predict the development of [post-operative AFib] in patients undergoing cardiac surgery.”

The study included a total of 327 patients undergoing isolated or combined cardiac surgery. The primary outcome was the development of post-operative AFib. Participants were divided into groups of patients who developed AFib after their surgery and those who did not, and their standard P wave parameters and PWPT were compared.

The frequency of post-operative AFib was 20.4% (n = 67). In patients who developed AFib, the P wave peak time in leads D2 (65.1 ± 11.8) and V1 (57.8 ± 18) were longer than those in patients without AFib (57.2 ± 10 and 44.8 ± 12.3, respectively; p <0.01). using multivariate regression analysis, the researchers confirmed that PWPT in leads D2 and V1 were independent predictors of AFib (odds ratio [OR] = 1.11; 95% confidence interval [CI], 1.02–1.21; p = 0.01 and OR = 1.06; 95% CI, 1.00–1.13; p = 0.03, respectively).

The authors emphasized that prediction of AFib in patients undergoing cardiac surgery is crucial, given that development of AFib is associated with increased risk of short- and long-term mortality and morbidity. According to their results, they suggested that the new ECG parameter, PWPT, is an effective marker for predicting post-operative AFib.