Amjad Khan, Manzar Zakaria, Sikandar Khan, Raheel Iftikhar.
Changes in p-wave amplitude and axis after treatment of chronic obstructive pulmonary disease exacerbation.
Pak Armed Forces Med J Jan ;65(1):48-52.

Objective: To compare the change in P-wave amplitude and axis before and after 24 hours of the treatment of chronic obstructive pulmonary disease exacerbation. Study Design: Quasi-experimental study. Place and Duration of Study: Department of medicine, PNS Shifa Karachi from Dec-2010 to June-2011 (six months). Material and Methods: A total of 93 subjects were included in the study. Their pre-treatment and post treatment ECGs were evaluated by measuring P-wave amplitudes in leads II and aVF and P-wave axes were calculated. The differences in terms of changes in P-wave amplitude and axis were compared. Results: Mean age of patients was 53.09 ± 7.20 years. Before treatment P-wave amplitude in lead II was 2.36 ± 0.34 mm and after treatment it was 1.73 ± 0.29 mm (p < 0.001). P-wave amplitude in lead aVF before treatment was 2.446 ± 0.334 mm while after treatment it was 1.556 ± 0.329 mm (p < 0.001). P-wave axis before treatment was 72.670 ± 4.670 and after 24 hours of treatment it was 63.750 ± 3.950 (p < 0.001). Conclusion: Significant changes in terms of reduction of P-wave amplitude and left ward rotation of P-wave axis occur after effective treatment of acute exacerbation of COPD. These findings provide valuable objective evidence in evaluating patient’s response to treatment and recommended to be used in clinical practice.

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