Relationship between P-wave duration and the risk of atrial fibrillation

ABSTRACT

Introduction: P-wave duration (PWD) is an electrocardiographic (ECG) marker reflecting atrial conduction, and studies have shown that its prolongation is associated with atrial fibrillation.

Areas covered: This review addresses the relationship between PWD and atrial fibrillation, how anatomic and physiologic changes in the atria potentiate the risk for atrial fibrillation, and how these atrial anatomic and physiologic changes relate to PWD. Other P-wave related entities, such as P-wave terminal force in V1, PR interval, and P wave axis are also addressed.

Expert commentary: Atrial fibrillation is a manifestation of the underlying atrial disease. Fibrotic collagen deposition interrupts the electrical flow and thus can potentiate the transition from sinus rhythm to atrial fibrillation. PWD is an ECG parameter that provides insight into the intricacies of the atria and could be a useful marker for assessing the risk for atrial fibrillation. The main obstacle for broad utilization of PWD is that it is not routinely reported on the printout of the electrocardiogram.

KEYWORDS:

• Atrial fibrillation
• P wave duration
• P wave terminal force
• PR interval
• atriopathy

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.