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Review article
DOI: 10.1016/j.rccl.2020.08.001
Available online 28 September 2020
P wave dispersion over two decades after its discovery. What the cardiologist should know
Dispersión de la onda P tras más de dos décadas de su descubrimiento. Lo que el cardiólogo debe saber
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Raimundo Carmona Puertaa,
Corresponding author
raimundocp@infomed.sld.cu

Corresponding author.
, Elizabeth Lorenzo Martínezb
a Department of Electrophysiology and Arrhythmology, Cardiovascular Hospital “Ernesto Guevara”, Santa Clara, Villa Clara, Cuba
b Department of Physiology, Medical University of Villa Clara, Santa Clara, Villa Clara, Cuba
Received 29 June 2020. Accepted 10 August 2020
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Table 1. Main studies demonstrating the predictive value of P wave dispersion for the occurrence of atrial fibrillation.
Abstract

For years, there has been an increase in cases of atrial fibrillation, reaching alarming levels. This is why intense work is done to find predictors of this arrhythmia. The electrocardiogram has shown to be useful for this purpose, and multiple indices derived from the P wave have been developed. Among the most notable is the P wave dispersion (PWD). It has been verified that PWD can predict the occurrence of paroxysmal atrial fibrillation in the absence of diseases as well as in the context of multiple cardiovascular pathologies or other systems. PWD is considered by most researchers to be the result of inhomogeneous conduction of the atrial electrical impulse, but a vector explanation may play a role in its genesis. The large body of evidence surrounding PWD supports its use in clinical practice.

Keywords:
Atrial conduction
Atrial fibrillation
Electrocardiogram
P wave dispersión
P wave indices
Abbreviations:
AF
PWD
Resumen

Desde hace años se han incrementado los casos de fibrilación auricular, alcanzándose niveles alarmantes, por lo que se trabaja intensamente en la búsqueda de predictores de esta arritmia. El electrocardiograma ha mostrado ser útil con este fin, y se han desarrollado múltiples índices derivados de la onda P. Entre los más notables se encuentra la dispersión de la onda P (Pd). Se ha comprobado que la Pd puede predecir la ocurrencia de fibrilación auricular paroxística tanto en ausencia de enfermedades como en el contexto de múltiples patologías cardiovasculares o de otros sistemas. La mayoría de los investigadores consideran que la Pd es el resultado de la conducción no homogénea del impulso eléctrico auricular, pero una explicación vectorial podría jugar un rol en su génesis. La amplia evidencia científica sobre la Pd avala su uso en la práctica clínica.

Palabras clave:
Conducción auricular
Dispersión de la onda P
Electrocardiograma
Fibrilación auricular
Índices de la onda P

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