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Abnormal P-wave terminal force in lead V1 is associated with low left atrial appendage ejection velocity
Journal of Electrocardiology ( IF 1.3 ) Pub Date : 2021-07-02 , DOI: 10.1016/j.jelectrocard.2021.06.011
Nathaniel McConkey 1 , Peter Malamas 1 , Faye L Norby 1 , Jovan Plamenac 1 , R Park 1 , F Weigel 1 , Mario Daniel Gonzalez 1 , Gerald V Naccarelli 1 , Ankit Maheshwari 1
Affiliation  

Background: Sinus P-wave abnormalities have been associated stroke in people with atrial fibrillation (AF). The majority of AF-related strokes occur from left atrial appendage (LAA) thromboembolism. Dysfunction of the left atrium (LA) and left atrial appendage (LAA) can increase rates of thromboembolic stroke. We studied whether abnormal P wave terminal force in V1 (aPTFV1) is associated with decreased LAA ejection velocity (LAAV) on transesophageal echocardiography (TEE).

Methods: We conducted a retrospective cross-sectional study reviewing patients at a tertiary care medical center who underwent TEE in sinus rhythm and had an interpretable sinus ECG within 12 months of TEE. Participants were excluded for complex congenital heart disease, age <18, cardiac transplantation, and chronic atrial pacing. Logistic regression analysis was used to estimate the odds ratios of LAAV<40 cm/s for aPTFV1.

Results: In our final cohort of 169 patients (28% of which had LAAV <40), the multivariate odds ratio of aPTFV1 for LAAV<40 cm/s after adjustment for CHA2DS2VASc variables, heart rate during TEE, history of atrial arrhythmias, and left atrial volume index was 2.24 (95% CI of 1.13–6.00).

Conclusion: Abnromal P-wave terminal force in lead V1 is associated with low LAAV after adjustment for potential confounders. Future research is needed for validation of our findings and determination of clinical utility.



中文翻译:

V1 导联异常 P 波终末力与左心耳射血速度低有关

背景:房颤 (AF) 患者的窦性 P 波异常与中风相关。大多数 AF 相关中风发生于左心耳 (LAA) 血栓栓塞。左心房 (LA) 和左心耳 (LAA) 的功能障碍会增加血栓栓塞性中风的发生率。我们研究了 V1 异常 P 波终末力 (aPTFV1) 是否与经食道超声心动图 (TEE) 上 LAA 射血速度 (LAAV) 降低有关。

方法:我们进行了一项回顾性横断面研究,审查在三级医疗中心接受窦性心律 TEE 并在 TEE 后 12 个月内具有可解释的窦性心电图的患者。参与者因复杂的先天性心脏病、年龄 <18 岁、心脏移植和慢性心房起搏而被排除在外。Logistic 回归分析用于估计 aPTFV1 LAAV<40 cm/s 的优势比。

结果:在我们 169 名患者(其中 28% 的 LAAV <40)的最终队列中,调整 CHA 2 DS 2 VASc 变量、TEE 期间的心率、病史后,aPTFV1 对 LAAV<40 cm/s 的多变量优势比房性心律失常,左心房容积指数为 2.24(95% CI 为 1.13-6.00)。

结论:在调整潜在混杂因素后,V1 导联异常 P 波终末力与低 LAAV 相关。未来的研究需要验证我们的发现和确定临床效用。

更新日期:2021-07-06
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