Effect of balloon-induced acute ischaemia on P wave dispersion during percutaneous transluminal coronary angioplasty

Aims P wave dispersion is a recent ECG marker that reflects discontinuous a nd inhomogeneous conduction of sinus impulses. which has been studied in a limited number of cardiac conditions, The aim of our study was to investiga te the effects of angioplasty induced-ischaemia on atrial conduction abnorm alities as estimated by P maximum and P dispersion. Methods and Results The study consisted of 67 consecutive patients (41 men, mean age 58 +/- 11 years) with 1-vessel coronary artery disease who underw ent elective single vessel coronary angioplasty (left anterior descending ( LAD) coronary artery in 28 patients, the right coronary artery (RCA) in 22 patients and the left circumflex coronary artery (LCx) in 17 patients. All patients underwent 12-lead surface ECG before the first inflation (baseline ) and then 60 s after intra-coronary balloon inflation. The maximum P wave duration, the minimum P wave duration, and P wave dispersion (Pd = Pmax - P min) were calculated from 12-lead surface ECGs. Baseline P wave duration me asurements were not significantly different among the patients with LAD, RC A and LCx coronary artery disease (P > 0.05). P dispersion and P maximum we re significantly higher during balloon occlusion compared with the baseline condition in all three types of coronary dilatation procedures. However, P minimum was not found to differ between baseline and during balloon occlus ion (P > 0.05). Conclusion The prolongation of P wave dispersion may be a useful and simple additional marker for myocardial ischaemia. (C) 2001 The European Society of Cardiology.