Predictive Value Of P Wave Peak Time In Predicting Patients With Paroxysmal Atrial Fibrillation

Objective To compare the relationship between a novel electrocardiographic(ECG)parameter P wave peak time(PWPT)and classic parameters with paroxysmal atrial fibrillation(AF).And to investigate whether the new ECG parameter P Peak time(PWPT)has predictive value for paroxysmal atrial fibrillation.Methods In this study,191 patients diagnosed with paroxysmal atrial fibrillation admitted to XXX Hospital Cardiovascular Medicine from January 2020 to December 2021 were randomly selected as the observation group.Meanwhile,A total of 1 9 8 patients with non paroxysmal atrial fibrillation admitted to the cardiovascular department during the same period as the control group.We need to collect the patients information,including:The clinical features,laboratory tests,echocardiography and electrocardiogram parameters of the two groups were recorded.Clinical characteristics included:age,gender,whether had smoking,alcohol consumption,Body mass index(BMI),history of hypertension and diabetes,and heart rate,systolic and diastolic blood pressure at admission;Laboratory indicators included:leukocyte,platelet,platelet volume distribution width,potassiumion,sodiumion,alanine aminotransferase,aspartate transferase,troponin,brain natriuretic peptide,urea nitrogen,serum,rate,triglyceride,and cholesterol.Echocardiography has the anterior and posterior,ventricular ejection and septal end sump thickness,and ascending aorta diameter.Ecg parameters include:PR interval,P wave dispersion,P wave maximum time,P wave minimum time,QT interval,QTC interval and the new parameter P wave peak time.Finally,by doing receiver operating curve(ROC)to analyze the predictive value of P peak time in patients with paroxysmal atrial fibrillation.Results1.A total of 3 89 patients with were collected in this study.Compared with the observation and another group,the observation group in the age(65.87± 10.80 years vs 56.41 ± 15.58 years,P<0.0 5)was older.And there were no significant differences in gender composition ratio,smoking history,drinking history,resting heart rate,systolic blood pressure,diastolic blood pressure,body mass index,history of hypertension,history of diabetes between the two groups(P>0.05).2.Compared with the control group,the creatinine value[75.20(50.10,74.40)umol/L vs 63.30(54.60,76.73)umol/L,P<0.05],urea nitrogen[6.97(3.80,6.42)umol/L vs 4.94(3.82,5.99)umol/L,P<0.05],NT-proBNP[144.78(103.23,314.81)pg/mlvs86.15(45.60,216.64)pg/ml,P<0.05]were higher.There was nosignificant difference between the observation group and the control group in leukocyte,platelet,platelet volume distribution width,blood potassium,sodium,triglyceride,cholesterol.(P>0.05).3.Compared with the control group,the observation group left atrium anterior and posterior was larger(40.54±3.54mm vs34.77±5.82mm,P<0.05).There were no significant differences between the two groups(P>0.05).Including:left ventricular ejection.4.Compared with control group,PR interval(168.40±40.06 ms vs151.26±20.80ms,P<0.05),P wave dispersion(51.47±6.83ms vs47.44±7.15ms,P<0.05),P wave maximum duration(121.20±22.15msvs109.77±15.53,P<0.05)QTcinterval(457.05±31.13ms vs365.71±31.49ms,P<0.05).but there was no significant difference in heart rate and QRS interval between the two groups(P>0.05).5.Compared with the control group,the PWPT duration of lead V1(56.32±8.26msvs 48.60±6.45ms,P<0.05)and lead Ⅱ(57.85±11.41ms vs51.07±7.39ms,P<0.05)was longer in the observation group.6.In the multivariate Logistic regression,and the results showed that:P wave dispersion(OR:1.041,95%CI1.08--1.29,P<0.005),P wave maximum duration(OR:1.224,95%CI1.041.43,P<0.005),PWPT(OR:1.288,95%CI 1.127--1.276,P<0.005),was found to be an independent predictor of PAF.We further drew the following conclusions in the ROC curve analysis:The area under the curve(AUC)of PWPT for V1 lead was 0.737,the area under the curve for P-wave dispersion was 0.661,and the area under the curve for PR duration was 0.63 8.It was found that PWPT for V1 lead was the best in predicting PAF risk in the whole study population,which was higher than the cutoff level of 4 9.5 msc.The sensitivity and specificity of predicting the occurrence of PAF were 76.0%and 80.6%.Conclusion1.Patients in the PAF were older.2.Creatinine,blood urea nitrogen,NT-proBNP and were higher in the observation group.3.The anteroposterior diameter of the left atrium was larger in the observation group.4.P wave maximum duration,、Pd、QT interval were longer in the observation group.5.The PWPT of lead V1 and lead Ⅱ was longer in the observation group.6.In the ROC,the area under the PWPTis closed to one.The PWPT of V1 lead greater than 49.5ms,which can predict the PAF.