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P-wave peak time and P-wave dispersion in surface electrocardiography as initial predictors of new-onset atrial fibrillation in early-onset hypertension

Hypertension Research volume 47, pages 137–148 (2024)Cite this article

Abstract

Atrial fibrillation (AF) is common in hypertension, and electrophysiological remodelling may contribute to the early stage of the disease. This study aimed to develop electrocardiography (ECG) prediction models on new-onset AF (NAF) in early-onset hypertension (e-HTN). This matched case-control study included primary hypertension patients with onset <5 years defined as e-HTN and without documented AF. Developed NAF was the risk group and non-developed NAF was control group with 1:2 ratio. Group was matched according to age, gender, follow-up time, and duration of hypertension. Parameters of ECG and echocardiography between the groups at the baseline and end of follow-up will be compared. A total of 348 e-HTN with 116 developed NAF during follow-up (60.2 ± 14.5 months) were included. At baseline ECG, duration of QRS (100.84 ms ± 15.69 ms vs 94.80 ms ± 15.68 ms), Pmax (106.75 ms ± 7.93 ms vs 101.77 ms ± 6.78 ms), Pmin (70.24 ms ± 5.59 ms vs 68.17 ms ± 5.61 ms), P-wave dispersion (PD) (36.50 ms ± 5.25 ms vs 33.60 ms ± 5.46 ms), P-wave Peak Time (PWPT) II (62.01 ms ± 3.92 ms vs 54.29 ms ± 6.73 ms), and PWPT V1 (55.31 ms ± 2.89 ms vs 51.24 ms ± 4.05 ms) were significantly higher in developed NAF (all P-value < 0.05). LVMI was also significantly higher in bivariate analysis, but only Pmax, Pmin, PD, PWPT, non-RAAS inhibitor, and uncontrolled hypertension were independently associated with developed NAF. Baseline PWPT II with cut-off ≥57.9 ms and PD ≥ 35.5 ms has high sensitivity and specificity on NAF prediction. In conclusion, baseline PWPT and PD are potential electrophysiological parameters for predicting NAF in e-HTN.

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Acknowledgements

We acknowledge I Made Junior Rina Artha, MD, PhD, FIHA, FAsCC, FAPSIC, FSCAI, FESC as our Head Department of Cardiology and Vascular Medicine, Prof. Dr. I.G.N.G Ngoerah General Hospital, Denpasar, Bali, Indonesia who gives us opportunity and general support to do this research.

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  1. Faculty of Medicine, Udayana University/Prof. dr. I.G.N.G Ngoerah General Hospital, Denpasar, Bali, Indonesia

    Gusti Ngurah Prana Jagannatha, Anastasya Maria Kosasih, Stanly Kamardi & I. Wayan Agus Surya Pradnyana

  2. Division of Electrophysiology and Cardiac Pacing, Department of Cardiology and Vascular Medicine, Udayana University/Prof. dr. I.G.N.G Ngoerah General Hospital, Denpasar, Bali, Indonesia

    I. Made Putra Swi Antara

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Jagannatha, G.N.P., Antara, I.M.P.S., Kosasih, A.M. et al. P-wave peak time and P-wave dispersion in surface electrocardiography as initial predictors of new-onset atrial fibrillation in early-onset hypertension. Hypertens Res 47, 137–148 (2024). https://doi.org/10.1038/s41440-023-01357-0

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