Relation of atrial electromechanical delay to P‐wave dispersion on surface ECG using vector velocity imaging in patients with hypertrophic cardiomyopathy

Objectives Heterogeneity of structural and electrophysiologic properties of atrial myocardium is common characteristic in hypertrophic cardiomyopathy (HCM). We assessed the dispersion of atrial refractoriness on surface ECG using P‐wave dispersion (PWD) and its relation to atrial electromechanical functions using vector velocity imaging (VVI) in HCM population. Methods Seventy‐nine HCM patients (mean age: 43.7 ± 13 years, 67% male) were compared with 25 healthy individuals as control. P‐wave durations, Pmax and Pmin, P‐wave dispersion (PWD), and P terminal force (PTF) were measured from 12‐lead ECG. LA segmental delay (TTP‐d) and dispersion (TTP‐SD) of electromechanical activation were derived from atrial strain rate curves. Results HCM patients had longer PR interval, PW duration, higher PWD, PTF, QTc compared to control (p 46 ms (n = 25) and group II PWD ≤ 46 ms (n = 54). Group I showed higher prevalence of female gender, higher PTF, QTc interval, left ventricular outflow tract (LVOT) obstruction, p