Effect of gender on P-wave dispersion in asymptomatic populations

Faulkner, Ashton; Garrett, Andrew

Abstract

Background: Exercise testing is a diagnostic tool for evaluating the induction of stress-induced paroxysmal atrial fibrillation (PAF). Resting P-wave dispersion has been suggested to be greater in males versus females but if used by clinicians, gender difference in response to exercise must be determined. Methods: Sixteen healthy subjects (n=8 male, age: 21±0.3; n=8 female, age: 23±1.4) performed an incremental exercise test using the Bruce protocol. Electrocardiograms were recorded at rest, end-exercise, 1, 3, and 5 mins recovery. P-waves were measured in each lead with the maximum (P-max) and minimum (P-min) P-wave durations and dispersion calculated. Results: There was a significant decrease in P-max from rest to end-exercise in males and females [males, 118.3±7.4 (95%CI: 109.7 to 126.8ms) vs. 97.9±6.2 (89.3 to 106.4ms); females, 109.4±4.5 (100.8 to 117.9ms) vs. 94.3±4.6 (85.7 to 102.8ms); p=0.001 (5.7 to 29.8ms)]. Similarly, for P-min [males, 65.6±5.6 (57.4 to 73.9ms) vs. 50.8±2.7 (42.5 to 59.0ms); females, 58.4±3.3 (50.1 to 66.6ms) vs. 45.6±2.7 (37.4 to 53.9ms); p=0.01 (2.2 to 25.4ms)]. Irrespective of gender there was limited change in P-wave dispersion in response to exercise. Males had a longer P-max versus females during the protocol [109.6±2.3 (105.8 to 113.4ms) vs. 103.6±1.8 (99.8 to 107.4ms); p=0.03] but this was not stage-specific. There was no gender differences in either P-min (p=0.12) or P-wave dispersion (p=0.64) across the protocol or stage-specific. Conclusions: Results from this study indicate that in contrast to P-max and P-min, the P-wave dispersion may not be significantly influenced by the sympathetic nervous system in males and females. Therefore, this study suggests males and females should be evaluated in the same way using the P-wave dispersion for predicting the development of stress-induced PAF at rest and during exercise testing protocols.

Citation

Faulkner, A., & Garrett, A. (2013). Effect of gender on P-wave dispersion in asymptomatic populations. International sportmed journal for FIMS ISMJ, 14(4), 236-244

• Journal Article Type: Article
• Acceptance Date: Jan 1, 2013
• Publication Date: 2013-12
• Deposit Date: Apr 20, 2015
• Publicly Available Date: Apr 20, 2015
• Journal: International sportmed journal
• Electronic ISSN: 1528-3356
• Peer Reviewed: Peer Reviewed
• Volume: 14
• Issue: 4
• Pages: 236-244
• Keywords: P-wave dispersion, Paroxysmal atrial fibrillation, Exercise, Gender
• Public URL: https://hull-repository.worktribe.com/output/372699
• Publisher URL: https://journals.co.za/content/ismj/14/4/EJC146797#abstract_content
• Additional Information: Author's accepted manuscript of article published in: International sportmed journal, 2013, v.14, issue 4
• Contract Date: Apr 20, 2015