Novel P Wave Indices to Predict Atrial Fibrillation Recurrence After Radiofrequency Ablation for Paroxysmal Atrial Fibrillation
Xiaoliang Hu, Jingzhou Jiang, Yuedong Ma, Anli Tang
(Cardiology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China (mainland))
Med Sci Monit 2016; 22:2616-2623
Circumferential pulmonary vein isolation (CPVI) is a widely used treatment for paroxysmal atrial fibrillation (AF). Several P wave duration (PWD) parameters have been suggested to predict post-ablation recurrence, but their use remains controversial. This study aimed to identify novel P wave indices that predict post-ablation AF recurrence.
MATERIAL AND METHODS: We selected 171 consecutive patients undergoing CPVI for paroxysmal AF. Electrocardiography (ECG) recordings were obtained at the beginning and the end of ablation. PWD was measured in all 12 leads. The PWD variation was calculated by subtracting the pre-ablation PWD from the post-ablation PWD.
RESULTS: PWD was significantly shortened in leads II, III, aVF, and V1 after ablation. During a mean follow-up of 19.96±4.32 months, AF recurrence occurred in 32 (18.7%) patients. No significant differences in baseline characteristics or pre- or post-ablation PWD were observed between the AF recurrence and non-recurrence groups. Patients with AF recurrence exhibited a smaller PWD variation in leads II (1.21(–0.56, 2.40) vs. –5.77(–9.10, –4.06) ms, P<0.001), III (–5.92(–9.87, 3.27) vs. –9.44(–11.89, –5.57) ms, P=0.001) and V1 (–4.43(–6.64, –3.13) vs. –6.33(–8.19,–4.59) ms, P=0.003). Multivariable logistic regression analysis demonstrated that smaller PWD variations in lead II and III were independent risk factors for AF recurrence. PWD variation ≥–2.21 ms in lead II displayed the highest combined sensitivity and specificity (85.29% and 8... read more
Keywords: Atrial Fibrillation, Catheter Ablation, Electrocardiography