Predictive Value of P-Wave Dispersion and P-Wave Peak Time for Development of Postoperative Atrial Fibrillation in Renal Transplant Recipients.

BACKGROUND Electrocardiography can predict development of postoperative atrial fibrillation (POAF). In renal transplant (RT) recipients, atrial fibrillation is associated with an increased risk of mortality, allograft failure, and stroke. Our study investigated whether P-wave dispersion (PWD) and P-wave peak time (PWPT) can predict the development of POAF in renal transplant recipients. MATERIAL AND METHODS We included 166 patients who underwent RT, divided into 2 groups based on the presence (POAF +) or absence (POAF -) of POAF. Preoperative PWD and PWPT were measured for each patient. RESULTS Smoking, hypertension (HT), chronic obstructive pulmonary disease, and coronary artery disease (CAD) were significantly more common in the POAF (+) group compared to the POAF (-) group. PreopPWD, PWPTDII, and PWPTV1 were significantly higher in the POAF (+) group compared to the POAF (-) group. Univariable logistic regression analysis showed that hypertension, chronic obstructive pulmonary disease, coronary artery disease, and electrocardiographic parameters, including preopPWD, PWPTDII, and PWPTV1, were significantly associated with POAF. Penalized regression analysis showed that HT, CAD, and preoperative PWD were independent predictors of POAF. CONCLUSIONS The integration of these non-invasive, cost-efficient, and readily accessible electrocardiographic parameters into preoperative evaluation protocols could substantially augment risk stratification paradigms, thereby facilitating the timely identification and preemptive management of patients predisposed to POAF.