Document Detail

Impact of pulmonary vein isolation on atrial late potentials: association with the recurrence of atrial fibrillation.
MedLine Citation:
PMID:  23059395     Owner:  NLM     Status:  Publisher    
AIMS: In patients with paroxysmal atrial fibrillation (AF), the P-wave signal-averaged electrocardiogram often demonstrates a low-amplitude potential at the terminal part of filtered P-wave (atrial late potential: A(LP)), which would originate from delayed pulmonary vein (PV) potentials. The aim of this study was to investigate the impact of PV isolation on P-wave morphology, and explore the association between A(LP) and AF recurrence after ablation.METHODS AND RESULTS: We enrolled 88 consecutive paroxysmal AF patients scheduled for ablation. The signal-averaged electrocardiogram was obtained at baseline and 1 day after ablation. An A(LP) was defined as a P-wave duration of ≥130 ms and a root-mean-squared voltage of the terminal 20 ms of ≤2.0 μV. A pre-procedural A(LP) was found in 37 (42%) patients and a post-procedural A(LP) was found in 26 (30%) patients. We completed PV isolation in all patients and followed them for 16 ± 4 months. The AF recurrence rate was 30% (26 patients) and was similar between patients with and without pre-procedural A(LP) (27 vs. 31%, respectively, P = 0.66); however, AF recurrence was significantly higher in patients with than without post-procedural A(LP) (54 vs. 19%, respectively, P = 0.001). In multivariate logistic regression analysis, post-procedural A(LP) was independently associated with AF recurrence (odds ratio = 4.22, 95% confidence interval = 1.52-11.7).CONCLUSION: Pulmonary vein isolation can modify A(LP) in a substantial number of patients with paroxysmal AF. Post-procedural A(LP) is associated with increased risk of future AF recurrence.
Masaharu Masuda; Koichi Inoue; Katsuomi Iwakura; Atsunori Okamura; Yuko Toyoshima; Atsushi Doi; Yohei Sotomi; Issei Komuro; Kenshi Fujii
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-10-11
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  -     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Cardiovascular Center, Sakurabashi Watanabe Hospital, 2-4-32, Umeda, Kita-ku, Osaka 530-0001, Japan.
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