Huseyin Dursun, Zulkif Tanriverdi, Tugce Colluoglu1, Dayimi Kaya. Effect of transcatheter aortic valve replacement on P-wave duration, P-wave dispersion and left atrial size[J]. Journal of Geriatric Cardiology, 2015, 12(6): 613-617. DOI: 10.11909/j.issn.1671-5411.2015.06.016
Citation: Huseyin Dursun, Zulkif Tanriverdi, Tugce Colluoglu1, Dayimi Kaya. Effect of transcatheter aortic valve replacement on P-wave duration, P-wave dispersion and left atrial size[J]. Journal of Geriatric Cardiology, 2015, 12(6): 613-617. DOI: 10.11909/j.issn.1671-5411.2015.06.016

Effect of transcatheter aortic valve replacement on P-wave duration, P-wave dispersion and left atrial size

  • Background P-wave dispersion (PWD), a measure of heterogeneity of atrial refractoriness, is defined as the difference between the maximum and minimum P-wave duration. In patients with severe aortic stenosis (AS), P-wave duration and PWD were shown to be increased, indicating atrial electrical remodeling. However, the effect of transcatheter aortic valve replacement (TAVR) on P-wave morphology has not been established yet. The aim of this study is to assess the short and long-term effects of TAVR with two types of bioprosthetic valves on P-wave duration and PWD in association with left atrial (LA) size. Methods Fifty-two (36 female) eligible patients in sinus rhythm who underwent transfemoral TAVR between June 01, 2012 and July 31, 2014 with either a Medtronic CoreValve (MCV) (n = 32) or an Edwards SAPIEN XT Valve (n = 20) were enrolled. Standard 12-lead electrocardiogram and echocardiographic evaluations were performed pre-procedurally, post-TAVR day one and 6 months post-TAVR. P-wave duration and PWD were measured and correlation analyses with echocardiographic variables were performed. Results P-wave duration and PWD were significantly decreased on post-TAVR day one (P P > 0.05). The decrease of LA diameter was found significant at the sixth-months of follow-up (P P > 0.05). A positive correlation was detected between minimum P-wave duration and maximum aortic valve gradients at post-TAVR day one (r = 0.297, P = 0.032). Conclusions P-wave duration and PWD were significantly reduced early after TAVR indicating early reverse atrial electrical remodeling. Moreover, structural reverse remodeling of atrium was detected at the 6-months of follow-up. The effects of two types of bioprosthetic valves on atrial remodeling were similar.
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