P wave dispersion and short-term vs. late atrial fibrillation recurrences after cardioversion

Background P wave dispersion has been previously suggested as a potential tool for predicting the risk of recurrence of atrial fibrillation after electrical cardioversion. We investigated whether different P wave dispersion values are associated with recurrence of atrial fibrillation in the short (≤1 month after cardioversion) and longer term. Methods In 37 patients with long-lasting persistent atrial fibrillation (mean duration 21±36 months) with (n=19) or without (n=18) amiodarone pretreatment as antiarrhythmic prophylaxis, maximum and minimum P wave duration and P wave dispersion were measured 1 min after internal cardioversion. Results P wave dispersion was lower in patients with amiodarone pretreatment (28.3±9.5 vs. 21.9±7.3 ms, P=0.029). The subgroups of patients with recurrence of atrial fibrillation at 1 month or in the long-term did not differ from the rest of the study sample regarding age, sex, atrial fibrillation duration, left atrial dimensions or ejection fraction. P wave dispersion was significantly higher in patients with short-term atrial fibrillation recurrence (≤1 month) than in the rest of the population. Furthermore, P wave dispersion values >25 ms were associated with a higher short-term relapse rate. No significant relation was present in the long-term. Conclusions Our results suggest that P wave dispersion analysis immediately after internal cardioversion may help predict short-term recurrences of atrial fibrillation. These findings may be related to different mechanisms and predisposing factors for short-term and late recurrences. The long-term predictive value of serial evaluations of P wave dispersion during follow-up deserves investigation.