El origen de la dispersión de la onda P resuelto - Fin de una era
Resumen
Desde hace más de dos décadas se utiliza la dispersión de la onda P (Pd) para la predicción de fibrilación auricular, pero no hay certeza de su mecanismo de producción en el electrocardiograma. Se han planteado dos teorías conocidas como local y vectorial. Utilizando técnicas de análisis vectorial y registros digitales magnificados en comparación con medidas de conducción auricular, se ha podido dilucidar cuál de las dos teorías justifica mejor la ocurrencia de la Pd. La teoría vectorial constituye la mejor explicación para el origen de este parámetro. La conducción atrial no homogénea (base de la teoría local) presenta una pequeña, aunque significativa contribución al origen de la Pd, pero solo cuando existe retraso dromotrópico interauricular. La justificación vectorial de la Pd desaconseja su uso en clínica cardiológica.
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