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Abnormal Atrial Activation at Surface Electrocardiogram Examination in Born Underweight Young Adults


Introduction. Literature published in recent years have described how subjects born preterm are at higher risk of developing atrial fibrillation (AF) in early adult life. Materials and methods. The surface electrocardiograms (ECG) of twenty-four adults, former preterm infants born with an extremely low birth weight (ex-ELBW; mean gestational age: 23.23.3 years; mean birth weight: 840+120.1 grams), were compared with those of 24 healthy counterparts born at term (C). A series of parameters known to be capable of predicting a predisposition to develop AF: P wave duration, dispersion, P terminal force, isoelectric interval length, and PR interval length, were also compared. Results. A shorter PR interval length was found in ex-ELBW compared to the same values in C (p<0.0003). Furthermore, longer P wave duration and dispersion, p terminal force, and isoelectric interval were detected in ex-ELBW than in C (p<0.0001, p<0.0001, p<0.01, and p<0.0004,respectively). P wave duration, PR interval length, and P wave dispersion were significantly correlated with birth weight (r=0.51 p<0.01, r=0.46 p<0.02, and r= 0.42 p<0.04, respectively). When excluding the possible influence of gestational age on birth weight, P wave duration and dispersion were found to be the only statistically significant determinants of abnormal atrial electrical activation (p<0.03 and p<0.04, respectively). On the contrary, when excluding the possible influence of birth weight on gestational age, only P wave duration remained statistically significant (p<0.05). Conclusions. Surface ECG findings of abnormal atrial activity in ex-ELBW may explain the previously reported predisposition to developing AF in these subjects.

Credits: Bassareo PP, Namana V, Puddu M , Marras S, Fanos V, Mercuro G



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