P wave duration changes and dispersion. A risk factor or autonomic dysfunction in stroke?

OBJECTIVE To investigate the P wave duration and P wave dispersion in stroke patients, and to compare those with healthy subjects. METHODS We measured maximum and minimum P wave durations, and dispersion on the 12-lead surface ECG in 67 consecutive patients with first ever-acute ischemic stroke and 58 controls at the neurology wards of the Medical School, Duzce, Turkey, between May 2005 and October 2006. The subjects were not included if there were a history of atrial fibrillation, cardiac problem, and using drugs related to cardiovascular diseases or psychiatric problems. RESULTS P wave durations and dispersion were similar in stroke patients and controls. The correlation analysis revealed a positive relation between age and Pmin duration (p=0.03). The mean Pmin values were 63.85+/-22.55 for male and 76.43+/-26.84 for female patients, and this difference was statistically significant (p=0.04). The correlations between P wave durations, and the presence of risk factors, the stroke outcome scales, and death of patient within 6 months were not statistically significant. CONCLUSION Although there were some previous reports on ECG changes including P waves in acute stroke, we found that P wave durations and dispersion were similar in acute stroke patients and controls. This may be related to the patient selection criteria of this study, as we did not include patients with any previous cardiac abnormality. We concluded that the autonomic nervous system dysfunctions causing cardiac abnormalities in stroke need more investigation.