Risk of atrial fibrillation in primary immunodeficiencies: evaluation of atrial electromechanical delay and P-wave dispersion.

BACKGROUND

Primary immunodeficiency diseases (PIDs) are an expanding group of rarely observed immune system disorders. Various clinical conditions, such as autoimmunity, immune dysregulation, and inflammation, could affect multiple organ systems in PID patients. The heart may be one of these organs; however, studies on this topic are rare. Atrial fibrillation (AF) is a significant cause of mortality and morbidity in the community and an increased P-wave dispersion (PWD) and atrial electromechanical delay (AED) are well-known markers indicating a predisposition to AF. We aimed to determine whether AED and/or increased PWD predict the early risk of AF in PID patients.

METHODS

This single-center, prospective controlled study included 61 PID and 60 control group patients. All participants underwent resting electrocardiography, echocardiography, and atrial electromechanical conduction time (AECT) monitoring using tissue Doppler imaging evaluated by an experienced cardiologist.

RESULTS

The PID group had a statistically significantly higher Pmax, Pmin, and PWD values, compared to the control group (102 [92-108] vs. 88 [82-99] ms, P < 0.001; 74 [70-80] vs. 68 [62-72] ms, P < 0.001; 26 [22-30] vs. 21 [18-26] ms, P = 0.001, respectively). Right atrial delay and interatrial delay were discovered to be statistically significantly higher in PID group (4 [2-6] vs. 2 [2-4] ms, P < 0.001; 6 [4-8] vs. 4 [4-6] ms, P = 0.039, respectively). Left atrial delay was also discovered to be high in the PID group, although this difference was not statistically significant (6 [4-6] vs. 4 [3-6] ms; P = 0.05).

CONCLUSION

We demonstrated that the well-known predictors of AF, AECT, and PWD were increased in PID patients. This result aids in the follow up and survival of PID patients, who experience multiple complications, by enabling the early identification of AF-related mortality and morbidity risk.