Efficacy of the Electrocardiographic P-Wave Indices (PWIs) in Predicting Atrial High-Rate Episodes (AHREs) With Cardiac Implantable Electronic Devices (CIEDs)

Abstract

Atrial fibrillation (AF) is a common arrhythmia that increases the risk of stroke and mortality. Patients with AF who have cardiac implantable electronic devices (CIEDs) are at risk of developing atrial high-rate episodes (AHREs), which can lead to adverse outcomes. Several electrocardiographic P-wave indices have been studied as potential predictors of AHREs, including P-wave duration (PWD), P-wave dispersion (PWDIS), P-wave peak time (PWPT), and PR interval. This review aimed to assess the efficacy of these P-wave indices in predicting AHREs in patients with AF and CIEDs. The review included studies that found that PWD and PWDIS were significantly associated with AHREs. Additionally, studies have shown that P-wave peak time and PR interval may also predict AHREs. However, limitations such as variability in cut-off values and differences in patient populations and CIED types suggest the need for standardized diagnostic criteria. Overall, P-wave indices may be useful in identifying patients at risk for AHREs, but further research is needed to establish their clinical utility.