1. P wave indices to predict atrial fibrillation recurrences post pulmonary vein isolation.
- Author
-
Salah A, Zhou S, Liu Q, and Yan H
- Subjects
- Aged, Atrial Fibrillation physiopathology, Atrial Fibrillation surgery, Biomarkers analysis, Catheter Ablation methods, Female, Heart Atria surgery, Humans, Male, Middle Aged, Predictive Value of Tests, Pulmonary Veins physiopathology, Recurrence, Sensitivity and Specificity, Atrial Fibrillation diagnosis, Electrocardiography standards, Heart Atria physiopathology, Pulmonary Veins surgery
- Abstract
Background: P-wave indices are appealing markers for predicting atrial fibrillation (AF) recurrences post ablation., Objective: This study evaluates the value of P wave indices to predict recurrences post pulmonary vein isolation (PVI) in patients with paroxysmal AF., Methods: We selected 198 patients (57 ± 8 years, 150 males) with symptomatic drug-refractory paroxysmal AF undergoing PVI in our hospital. A 12-lead electrocardiogram was used to measure P wave duration in lead II, P wave terminal force (PWTF) in lead V1, P wave axis and dispersion., Results: During a follow-up of 9 ± 3 months, recurrences occurred in 60 (30.3%) patients. The patients that had AF recurrence had longer mean P wave duration (122.9 ± 10.3 vs 104.3 ± 14.2 ms, p < 0.001), larger P wave dispersion (40.7 ± 1.7 ms vs 36.6 ± 3.2 ms, p < 0.001). P wave duration > 125 ms has 60% sensitivity, 90% specificity, positive predictive value (PPV) of 72% and negative predictive value (NPV) of 83.7%, whereas P wave dispersion > 40 ms has 78% sensitivity, 67% specificity, PPV of 51% and NPV of 87.6% 48/66 (72.7%) patients with PWTF < -0.04 mm/second vs 12/132(9%) with PWTF > -0.04 mm/second showed recurrence of AF (p < 0.001). P wave axis was not different between two groups. On multivariate analysis, P wave indices were not independent from left atrial size and age., Conclusions: P wave duration > 125 ms, P wave dispersion > 40 ms and PWTF in V1 < -0.04 mm/sec are good clinical predictors of AF recurrences post PVI in patients with paroxysmal atrial fibrillation; however they were not independent from left atrial size and age.
- Published
- 2013
- Full Text
- View/download PDF