P-wave duration and dispersion in patients with peripheral edema and its amelioration

BACKGROUND: Attenuation of the P-wave amplitudes in patients with peripheral edema (PERED) has been recently reported, with P-waves regaining some of their amplitude in patients, who subsequently experienced amelioration of their PERED. Changes in the P-waves correlated with the corresponding alterations in the QRS complexes. Also since amplitudes and durations of QRS complexes changed in parallel in patients with PERED, it was hypothesized that similar changes in the P-wave amplitudes, mean P-wave duration (P-du-mean), and P-wave dispersion (P-d), would occur in such patients. METHODS: Measurements of P-wave amplitude, P-du-mean and P-d in patients who developed, or experienced alleviation, of PERED, were carried out and analyzed. RESULTS: Although P-wave amplitudes and P-wave areas decreased with development of PERED (N = 16), and increased with its amelioration (N = 6), P-dur-mean before PERED was 66.8±14.5 ms, and at peak weight gain it was 65.2±11.9 ms, p = 0.66; also at peak weight gain and subsequent lowest weight, in the patients who lost weight, it was 66.5±9.9 ms and 72.3±12.0 ms, respectively, p = 0.38. Similarly the P-d prior to PERED was 62.3±25.2 ms, and at peak weight gain it was 74.3±29.3 ms, p = 0.09; also at peak weight and subsequent lowest weight, in the patients who lost weight, it was 58.8±34.2 ms, and 61.3±13.6 ms, respectively, p = 0.87. CONCLUSION: P-du-mean and P-d did not change in patients who developed PERED; their stability is attributed to the offsetting of the electrophysiologically-mediated real changes, by opposite apparent changes, imparted by PERED.