Document Detail


P-wave indices as predictors of atrial fibrillation recurrence after pulmonary vein isolation in normal left atrial size.
MedLine Citation:
PMID:  25490249     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
AIMS: Prolonged P-wave duration and dispersion are universally accepted noninvasive markers for atrial electrical remodeling. Our aim was to analyze P-wave indices as predictors of atrial fibrillation recurrence after pulmonary vein isolation in patients with normal left atrial size.
METHODS: From January 2008 to December 2011, 426 patients with drug-resistant symptomatic paroxysmal atrial fibrillation underwent pulmonary vein isolation as an index procedure by conventional radiofrequency or cryoballoon ablation in our center. Patients with left atrial dilatation, poor-quality electrocardiograms, atrial pacemaker stimulation, and those undergoing repeat procedures were excluded. A total of 201 patients were analyzed during a mean follow-up of 22 ± 16 months.
RESULTS: Patients with prolonged P-wave duration had higher rates of atrial fibrillation recurrences compared with those without prolonged P-wave duration (49 vs. 14%; P < 0.001). Atrial fibrillation recurrence was significantly associated with prolonged P-wave duration (129 ± 13 vs. 119 ± 11 ms; P < 0.001) and P-wave dispersion (54 ± 12 vs. 42 ± 10 ms; P < 0.001) compared with those who remained in sinus rhythm. P-wave duration and dispersion were independently associated with atrial fibrillation recurrence (hazard ratio 1.045, 95% confidence interval 1.027-1.063, P < 0.001; and hazard ratio 1.049, 95% confidence interval 1.022-1.078, P < 0.001, respectively), after adjusting for left atrial size and age.
CONCLUSION: Prolonged P-wave duration and dispersion were found to be independently associated with higher recurrence rates of atrial fibrillation after pulmonary vein isolation in patients with normal left atrial dimension. Therefore, a prolongation of P-wave indices may help to identify those patients in whom electrical remodeling has already occurred and a more extensive ablation may be indicated.
Authors:
Giacomo Mugnai; Gian-Battista Chierchia; Carlo de Asmundis; Justo Juliá; Giulio Conte; Juan Sieira-Moret; Lucio Capulzini; Kristel Wauters; Moises Rodriguez-Mañero; Giuseppe Ciconte; Giannis Baltogiannis; Giacomo Di Giovanni; Yukio Saitoh; Pedro Brugada
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-12-8
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  -     ISSN:  1558-2035     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2014 Dec 
Date Detail:
Created Date:  2014-12-9     Completed Date:  -     Revised Date:  2014-12-10    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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