Shorter Minimum P-Wave Duration Is Associated with Paroxysmal Lone Atrial Fibrillation

Abstract Background and Purpose Prolonged P-wave dispersion (PWD) and P-wave duration (PWdur) have been found to be associated with common atrial fibrillation (AF), but the association of P-wave indices with lone atrial fibrillation (LAF) is unclear. Methods We enrolled 61 paroxysmal LAF cases and 150 controls without AF. P-wave indices were measured from a 12-lead ECG. Multivariable logistic regression was used to assess the association between P-wave indices and LAF. Results PWD was longer in LAF patients (median, IQR; 54.1 [42.9–63.2] ms) than controls (46.0 [38.5–57.7] ms), P = 0.03. MinPWdur was shorter in LAF patients (60.5 [50.7–72.6] ms) than controls (66.0 [55.5–76.4] ms), P = 0.03. In multivariable models, only the association between shorter minPWdur and LAF remained statistically significant (OR [95% CI] per tertile increment in minPWdur, 0.64 [0.42–0.95], P = 0.03). Conclusions Unlike common AF, paroxysmal LAF is independently associated with shorter minPWdur. This finding suggests that both shorter and prolonged PWdur may be associated with increased risk of AF.