The Evaluation of P-Wave Parameters in Patients With Percutaneous Closure of Atrial Septal Defect

Abstract

Background: Atrial septal defect (ASD) can lead to volume overload and related changes in P-wave parameters in surface electrocardiograms of these patients. In this study, we aimed to evaluate the effect of volume overload on P-wave parameters in patients with ASD. Materials and methods: This study is a retrospective cohort analysis. A total of 142 patients with secundum ASD who underwent percutaneous closure were evaluated. P-wave duration (Pmax) and P-wave dispersion (PWD) were measured on the surface ECG before and 1 h after the closure procedure. We evaluated P-wave parameters in terms of defect size, duration of the volume overload, and closure device sizes. Results: Pmax and PWD were significantly decreased after the procedure compared with the values before the procedure (p < 0.001). Pmax values had a statistically significant correlation with ASD size (< 20 mm or >= 20 mm) both before and after the procedure. Pmax values were significantly higher in patients older than 30 years of age (119.6 +/- 19.5 vs. 102.7 +/- 17.1 ms, respectively; p = 0.039). A significantly positive correlation was found between pre- and post-procedural Pmax and defect sizes (r = 0.474, p = 0.019 and r = 0.4233, p = 0.04, respectively). However, no positive correlation between PWD and defect age and size was present. Conclusion: Percutaneous closure of ASD is associated with an immediate decrease in both Pd and Pmax that seems to be related to the acute volume overload cessation in cardiac chambers.