Article

OBJECTIVE: To provide information about the effect of autonomic dysfunction on
P-wave dispersion, as a predictor of atrial fibrillation, in patients with spinal
cord injury. DESIGN: Thirty patients with chronic traumatic spinal cord injury
and 27 healthy controls were included in this study. The initial assessment of
the patients included routine physical examination and evaluation of 12-lead
electrocardiography. In the patient group, blood pressure and electrocardiography
recordings were obtained during urodynamic assessment. The measurements of the
P-wave duration were performed manually by two blinded investigators. P-wave
dispersion was calculated as the difference between maximum P-wave duration and
minimum P-wave duration. P-wave dispersion values of resting electrocardiography
recordings in control and study groups were compared. In the patient group,
subgroup analyses were also performed according to the injury level and severity
and existence of autonomic dysfunction in examinations. RESULTS: P-wave
dispersion values were greater in patients with spinal cord injury than in
healthy controls. There was statistically significant difference between P-wave
dispersion values of the patients with and without autonomic dysfunction. P-wave
dispersion values at initial sensation of vesical filling were greater than those
of the resting state in the patients without autonomic dysfunction. CONCLUSIONS:
Our findings indicate that P-wave dispersion increases significantly in chronic
spinal cord injured patients with autonomic dysfunction. This finding suggests a
tendency for atrial fibrillation occurrence in patients with spinal cord injury,
which may cause further cerebrovascular complications in this special subset of
patients by creating a thromboembolic milieu.

Langue : ANGLAIS