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Comparative Study
. 2021 Apr 6;21(1):164.
doi: 10.1186/s12872-021-01930-w.

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

Ruibin Li  1 , Xiaohong Yang  1 , Min Jia  1 , Dong Wang  1 , Xiaoran Cui  1 , Long Bai  1 , Lei Zhao  1 , Jidong Zhang  2
Affiliations
Comparative Study

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

Ruibin Li et al. BMC Cardiovasc Disord. .

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.

Keywords: Left atrial appendage volume; P-wave ECG index; Radiofrequency catheter ablation of atrial fibrillation; Recurrence.

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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Fig. 1
Fig. 1
Pmax in the 12-lead ECG. The maximum width of P wave is 128 ms
Fig. 2
Fig. 2
Pmin in the 12-lead ECG. The minimum width of P wave is 106 ms
Fig. 3
Fig. 3
PtfV1 = duration (s) × P-wave terminal amplitude (mV). The P duration was 0.053 s, and P-wave terminal amplitude was 0.23 mV
Fig. 4
Fig. 4
Three-dimensional volume of the left atrium in CT
Fig. 5
Fig. 5
Three-dimensional volume of the left atrial appendage in CT
Fig. 6
Fig. 6
ROC curve of P wave dispersion predicting the recurrence of atrial fibrillation after catheter ablation
Fig. 7
Fig. 7
ROC curve of maximum P-wave duration predicting the recurrence of atrial fibrillation after catheter ablation
Fig. 8
Fig. 8
ROC curve of V1 lead P-wave terminal potential predicting the recurrence of atrial fibrillation after catheter ablation
Fig. 9
Fig. 9
Kaplan–Meier curve analysis of the time to recurrence of atrial fibrillation after catheter ablation when PtfV1 ≥ 0.04 mV·s
Fig. 10
Fig. 10
Kaplan–Meier curve analysis of the left atrial appendage volume and AF-free survival after AF ablation
See this image and copyright information in PMC

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