Anorexia nervosa (AN) is an increasingly common medical condition. Some studies have demonstrated an increased prevalence of atrial premature contractions and anatomical changes in AN patients. Our aim was to investigate P wave parameters and P wave dispersion, an electrocardiographic marker for supraventricular arrhythmias, and its effect on AN. The study group included 48 patients with AN, most hospitalized for a few weeks, and a matched control group. All participants underwent 12-lead electrocardiography (ECG) under strict standards. P wave length and P wave dispersion in each patient were computed from a randomly selected beat and an averaged beat, constructed from 7 to 12 beats, included in a 10-s ECG. There were no statistically significant differences found between the groups for minimal, maximal, average P wave duration and P wave dispersion, calculated either from a random beat or averaged beats. In conclusion, medically treated AN patients who have gained weight have normal P wave parameters, and therefore do not appear to have an increased electrocardiographic risk for atrial fibrillation compared with healthy controls. Further studies are required to evaluate the influence of different disease stages, electrolyte imbalance and other medical complications on P wave parameters and risk for supraventricular arrhythmias in AN patients.
Anorexia nervosa (AN) is a psychiatric condition which has become increasingly common in recent decades. This condition is characterized by a fear of gaining weight, failure to maintain a minimally normal weight, and a preoccupation with body shape (Chakraborty and Basu, 2010). Among the many psychiatric disorders, AN sufferers have the highest mortality rate (Zenker et al., 2010). AN was reported to be associated with reduced cardiac mass, and ventricular dysfunction (Galetta et al., 2005), although other reports have concluded that systolic dysfunction may not be observed (Gottdiener et al., 1978). In addition, it was reported that AN was associated with electrocardiographic abnormalities, such as abnormal repolarization (Takimoto et al., 2004).
Atrial fibrillation is a common arrhythmic disorder and an independent risk factor for early death and clinical complications (Falk, 2001 and Page, 2004). P wave dispersion (Pd) is an electrocardiographic marker calculated from a 12-lead electrocardiogram (ECG) by subtracting the shortest from the longest P-wave interval measured from a single beat. Calculation of Pd is based on the assumption that each surface P wave length correlates with the regional activation of the atria (Michelucci et al., 2002 and Nussinovitch et al., 2010). It has been suggested that Pd could be used in evaluating the risk of developing supraventricular arrhythmias, and in particular, atrial fibrillation (Dilaveris and Gialafos, 2001). Hanci et al. reported that malnutrition (diagnosed according to serum albumin levels, and weight loss during the preceding 6 months) was associated with increased Pd values (Hanci et al., 2010).
Premature atrial contractions were reported in small cohorts of AN patients (Dec et al., 1987 and Campanini et al., 1991). There are also anecdotal reports on atrial contractile abnormalities and electro-mechanical dissociation in AN (Mizuno et al., 1998). Therefore, our aim was to evaluate whether AN is associated with abnormalities of the Pd and other P wave parameters. To the best of our knowledge, no similar reports have been published on the subject.
