Bülent DEVECI, Mehmet ARSLAN, Hasan BOZKURT

P dalga dispersiyonu ve P dalgası süresi parametrelerinin CHA2DS2-VASc Skoru ile bağımsız ilişkisi

AMAÇ: Atriyal fibrilasyon, yüksek inme riski mortalitesini de kapsayan,belirgin şekilde morbiditeyle ilişkilendirilen yaygın bir bozukluktur. Atriyum direnç süresinin kısalması ve iletim hızının düşürülmesi gibi "atriyal yeniden şekillendirme" denilen atriyal yapısal ve elektrofizyolojik değişiklikler, kalıcılığını artırır. Bu hasta grubunda: klinik tedavi kılavuzları antikoagülasyonu önemle tavsiye etmektedir. Bu öneriler, yayımlanmış şemalara dayanmaktadır. Ayrıca çok sayıda çalışma, p-dispersiyonu ve p-dalga süresi parametrelerinin atriyalfibrilasyon riski ile ilişkili olduğunu ortaya koymuştur. Biz burada, CHA2DS2-VASc değeri ile P dalgası dispersiyon parametreleri arasındaki ilişkiyi inceleyeceğiz. GEREÇ VE YÖNTEMLER: Çalışmaya toplam 257 hasta dahil edilmiş olup hastalara ait CHADS ve CHA2DS2-VASc değerleri, tıbbi geçmişleri, kullandıkları ilaçlar ve sosyal güvenlik kurumu raporlarından elde edilmiştir. Dışlama kriteri olarak; kalp kapak hastalığı ve amiodarone, meksiletin kullanımı belirlendi. Maksimum (pmax) ve minimum (pmin) P-dalgası sürelerinin yanı sıra P-dalgası dispersiyonu, birden fazla farklı yüzey EKG uçlarından kaydedilen maksimum ve minimum P- dalgası süresi arasındaki fark olarak tanımlandı. BULGULAR: Katılımcıların %29,2’si kadın, yaş ortalamaları 60,76±15,42; CHA2DS2-VASc skorları ise 3,20±1,91’di. P-dalgası parametrelerinin yaşla ilişkisinin olmadığı görülmüştür. P-ortalama, P-maksimumve P-dispersiyonunun CHADS ile çok zayıf düzeyde; P-ortalama ve P-maksimum süresinin CHA2DS2-VASc Score ile çok zayıf düzeyde korelasyon gösterdiği bulunmuştur (p

Anahtar Kelimeler:

Atrial fibrilasyon, CHA2DS2-VASc, p dalga dispersiyonu

Independent association of P-wave dispersion and P-wave duration parameters with CHA2DS2-VASc value

AIM: Atrial fibrillation is a common disorder associated with markedly high stroke morbidity and mortality.Atrial structural and electrophysiological changes called "atrial reshaping" such as shortening of atrial resistance time and reduction of conduction velocity increase the persistence of atrial fibrillation.In this patient group: clinical management guidelines strongly recommend anticoagulant therapy. These recommendations are based on published charts. In addition, many studies have revealed that the p-dispersion and p-wave duration parameters are associated with the risk of atrial fibrillation. Here, we will examine the relationship between the CHA2DS2-VASc value and the P wave dispersion parameters. MATERİAL AND METHODS: A total of 257 patients were included in the study, and the patients' CHADS and CHA2DS2-VASc values were obtained from their medical history, medications they used, and social security institution reports. As exclusion criteria; valvular heart disease and the use of amiodarone and mexiletine were determined. P-wave dispersion as well as maximum (pmax) and minimum (pmin) P-wave durations were defined as the difference between the maximum and minimum P-wave duration recorded from multiple different surface ECG leads. RESULTS: 29.2% of the participants were female, their mean age was 60.76±15.42; CHA2DS2-VASc scores were 3.20±1.91. It was observed that the P-wave parameters were not correlated with age. P-mean, P-maximum, and P-dispersion with CHADS very poorly; It was found that the P-mean and P-maximum time correlated very poorly with the CHA2DS2-VASc Score (p

Keywords:

Atrial fibrillation, CHA2DS2-VASc, p wave dispersion,

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