• Ahmet Öz, Tufan Cinar, Cansu Kızılto Güler, Süleyman Çağan Efe, Ufuk Emre, Turgut Karabağ, and Burak Ayça.
• Cardiology, Istanbul Teaching and Research Hospital, Istanbul, Turkey drozahmet@gmail.com.
• Postgrad Med J. 2020 Oct 1; 96 (1140): 584-588.

IntroductionIn this study, we aimed to investigate the usefulness of P wave peak time (PWPT), a novel ECG parameter, in patients who were diagnosed with acute ischaemic stroke (IS) and had paroxysmal atrial fibrillation (PAF) on Holter monitoring.Materials And MethodsIn this retrospective cohort study, we included 90 consecutive patients with acute IS who were admitted to our hospital between January 2017 and July 2019. PWPT was described as the time from the beginning of the P wave to its peak, and it was measured from leads DII and VI. The PAF diagnosis was confirmed if it was detected on the ECG during palpitation or in rhythm during the Holter recordings.ResultsIn this study, 34 (37.7%) patients with acute IS were diagnosed with PAF. In multivariate analyses, the independent predictors of PAF were age, PWPT in lead VI and PWPT in lead DII (OR: 1.34, 95% CI 1.15 to 1.56; p<0.001). A receiver operating curve analysis demonstrated that area under the curve values for PWPT in lead DII for PAF were 0.88 (95% CI 0.81 to 0.95, p<0.001). The cut-off value for PWPT in lead DII in predicting PAF was 68.5 ms with a sensitivity of 82.4% and a specificity of 75.0%.ConclusionTo the best of our knowledge, this is the first study to demonstrate a significant relationship between PWPT in lead DII and PAF among patients with acute IS.© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

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