Predicting Atrial Fibrillation Recurrence After Catheter Ablation Through Time Variability of P-wave Features

Atrial fibrillation is the most common type of cardiac arrhythmia in clinical practice. Currently, catheter ablation for pulmonary-vein isolation is a well-established treatment for maintaining sinus rhythm when antiarrhythmic drugs do not succeed. Unfortunately, arrhythmia recurrence after catheter ablation remains common, with estimated rates of up to 45%. A better understanding of factors leading to atrial-fibrillation recurrence is needed. Hence, the aim of this study is to characterize changes in the atrial propagation pattern following pulmonary-vein isolation, and investigate the relation between such characteristics and atrial-fibrillation recurrence. Fifty patients with paroxysmal atrial fibrillation who had undergone catheter ablation were included in this study. Time-segment and vectorcardiogram-loop-morphology analyses were applied to characterize P waves extracted from 1 min long 12-lead electrocardiogram segments before and after the procedure, respectively. Results showed that P-wave vectorcardiogram loops were significantly less round and more planar, P waves and PR intervals were significantly shorter, and heart rate was significantly higher after the procedure. Differences were larger for patients who did not have arrhythmia recurrences at 2 years of follow-up; for these patients, the pre- and postprocedure P waves could be identified with 84% accuracy.

Download Full-text

Left Atrial Appendage Flow Velocity and Time from P-Wave Onset to Tissue Doppler-Derived A' Predict Atrial Fibrillation Recurrence after Radiofrequency Catheter Ablation

Echocardiography ◽

10.1111/echo.12823 ◽

2014 ◽

Vol 32 (7) ◽

pp. 1101-1108 ◽

Cited By ~ 13

Author(s):

Keiko Fukushima ◽

Noritoshi Fukushima ◽

Koichiro Ejima ◽

Ken Kato ◽

Yasuto Sato ◽

...

Keyword(s):

Atrial Fibrillation ◽

Catheter Ablation ◽

Flow Velocity ◽

Left Atrial ◽

Radiofrequency Catheter Ablation ◽

Left Atrial Appendage ◽

Tissue Doppler ◽

P Wave ◽

Atrial Appendage ◽

Atrial Fibrillation Recurrence

Download Full-text

Effectiveness of P-wave ECG index and left atrial appendage volume in predicting atrial fibrillation recurrence after first radiofrequency catheter ablation

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-01930-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ruibin Li ◽

Xiaohong Yang ◽

Min Jia ◽

Dong Wang ◽

Xiaoran Cui ◽

...

Keyword(s):

Atrial Fibrillation ◽

Catheter Ablation ◽

Radiofrequency Catheter Ablation ◽

P Wave ◽

Atrial Fibrillation Recurrence ◽

Interval Prolongation ◽

Wave Duration ◽

P Wave Duration ◽

Pr Interval ◽

Recurrence Group

Abstract Background The primary aim was to observe the predictive value of P-wave ECG index and left atrial appendage volume (LLAV) for atrial fibrillation recurrence after first radiofrequency catheter ablation. Methods A total of 196 patients with paroxysmal atrial fibrillation were enrolled. The preoperative LLAV was measured by cardiac enhanced CT. The P-wave ECG index including minimum P-wave duration (P-min), maximum P-wave duration (P-max), mean P-wave duration (mPWD), P-wave dispersion (PWD), P-wave terminal force in lead V1 (PtfV1), PR interval prolongation, and interatrial block (IAB) were analyzed and recorded in 12-lead ECG of sinus rhythm. Results According to the follow-up results, the patients were divided into two groups: the non-recurrence group and the recurrence group. P-min, PWD, P-max, PtfV1 ≥ 0.04 mV·s, PR interval prolongation, and the ratio of first and third-degree IAB in the recurrence group were higher than those in the non-recurrence group, with significant statistical differences (P < 0.05). Kaplan–Meier curve analysis was performed on time to atrial fibrillation recurrence after catheter ablation when PtfV1 ≥ 0.04 mv s by comparison between groups (Log Rank test: 2 = 4.739, P < 0.001). Kaplan–Meier curve analysis showed that the survival rate without recurrence of atrial fibrillation after catheter ablation was lower when the LLAV exceeded 8.0 mL (log-rank test P < 0.001). Conclusion PWD, P-max, PtfV1, PR interval prolongation, first and third-degree IAB, and LLAV can effectively predict atrial fibrillation recurrence after radiofrequency catheter ablation. The combination might be a valid and alternative independent predictor of recurrence.

Download Full-text