Electrocardiogram P-wave sign is related to new-onset atrial fibrillation of patients with acute myocardial infarction

Abstract

Objective To investigate the relationship between dynamic electrocardiogram P-wave sign and new-onset atrial fibrillation (NOAF) in patients with acute myocardial infarction (AMI)(AMI-NOAF). Methods Totally 240 patients with AMI admitted to Wuwei Cancer Hospital were examined by dynamic electrocardiogram. P-wave sign parameters and clinical data of holter electrocardiogram were collected. The relationship between P-wave sign and clinical parameters of AMI patients was analyzed. The patients were divided into NOAF group and nonoccurrence(non-NOAF) group and multivariate Logistic regression model was used to identify the influencing factors of NOAF occurrence in AMI. Results Killip Ⅲ-Ⅳ grade minimum P wave duration (Pmin) level was shorter than that of Ⅰ-Ⅱ grade. Maximum P wave duration (Pmax) and P wave dispersion (Pd) level were higher than that of Ⅰ-Ⅱ grade(P＜0.05). NOAF occurred in 47 of 240 AMI patients (19.58%). The level of Pmin in NOAF group was lower than that in non-NOAF group, and the level of Pmax and Pd in NOAF group was higher than that in non-NOAF group(P＜0.05). The heart rate and the proportion of Killip grade Ⅲ-Ⅳ in NOAF group were higher than those in non-NOAF group(P＜0.05). Multivariate Logistic regression analysis showed that Killip Ⅲ-Ⅳgrade, high level of Pmax and Pd were independent risk factors for NOAF in AMI (P＜0.05). Conclusions The level of Pmin, Pmax and Pd are correlated with Killip grading in AMI patients. AMI-NOAF patients have abnormal P-wave sign in holter electrocardiogram. The high levels of Pmax and Pd are independent risk factors of AMI and NOAF.

Keywords

• acute myocardial infarction|atrial fibrillation|dynamic electrocardiogram|p-wave sign|conduction block