| Prediction of the efficacy of pulmonary vein isolation for the treatment of atrial fibrillation by the signal-averaged P-wave duration. | |
| | |
MedLine Citation:
|
PMID: 17367349 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: The noninvasive methods for predicting a successful pulmonary vein isolation (PVI) have not been well described. The aim of this study was to assess the usefulness of the P-wave signal-averaged electrocardiogram (P-SAECG) in predicting the chance of a successful PVI in patients with atrial fibrillation (AF). METHODS: A P-SAECG was recorded before (pre), 1 day after, and 3-4 months after the PVI in 51 AF patients (41, paroxysmal AF; 10, persistent AF). Three-dimensional electroanatomic mapping (3D-EAM) of the right and left atria and left PVs was performed before PVI in 10 patients to analyze the biatrial conduction time (BAT). RESULTS: Fifteen patients suffered from AF recurrences 3 months or more after the PVI. The pre-filtered P-wave duration (FPD) was significantly longer in patients with recurrence than in those without (166.8 +/- 14.8 ms vs 145.9 +/- 12.6 ms, P < 0.0001). In both patient groups, PVI shortened the FPD, which continued for 3-4 months. Multivariate analysis revealed that a pre-FPD >150 ms was a powerful predictor for recurrence, but persistent AF, the left atrial dimension, and structural heart disease were not predictors for recurrence. 3D-EAM showed that the delayed activation point was located within the left PVs and the BAT was identical to the pre-FPD. CONCLUSIONS: The pre-FPD may strongly reflect atrial dysfunction, and thus may be useful for predicting a successful PVI. Shortening of the FPD after the PVI and similar FPD and BAT values suggest that the last component of the FPD represents the activation of the left PVs. |
| | |
Authors:
|
Yasuo Okumura; Ichiro Watanabe; Kimie Ohkubo; Sonoko Ashino; Masayoshi Kofune; Kenichi Hashimoto; Atsushi Shindo; Hidezou Sugimura; Toshiko Nakai; Yuji Kasamaki; Satoshi Saito |
Related Documents
:
|
15845559 - Pre-operative atrial fibrillation as the key determinant of outcome of mitral valve rep... 18625529 - Statins and prevention of atrial fibrillation in patients with heart failure. 12396229 - New approaches to atrial fibrillation management: a critical review of a rapidly evolvi... 12918849 - Impact of left atrial size reduction on chronic atrial fibrillation in mitral valve sur... 19437399 - Atrioventricular node ablation is not a prerequisite for cardiac resynchronization ther... 19106009 - The association between previous statin use and development of atrial fibrillation in p... 21411159 - Myocardial hypertrophy after pulmonary regurgitation and valve implantation in pigs. 6255219 - Comparison of cardiac lesions induced in rats by isoproterenol and by repeated stress o... 18179909 - Custom-tailored valved conduit for complex aortic root disease. |
Publication Detail:
|
Type: Controlled Clinical Trial; Journal Article |
Journal Detail:
|
Title: Pacing and clinical electrophysiology : PACE Volume: 30 ISSN: 0147-8389 ISO Abbreviation: Pacing Clin Electrophysiol Publication Date: 2007 Mar |
Date Detail:
|
Created Date: 2007-03-19 Completed Date: 2007-05-31 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 7803944 Medline TA: Pacing Clin Electrophysiol Country: United States |
Other Details:
|
Languages: eng Pagination: 304-13 Citation Subset: IM |
Affiliation:
|
Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan. yasuwook@yahoo.co.jp |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Aged Aged, 80 and over Atrial Fibrillation / diagnosis*, surgery* Diagnosis, Computer-Assisted / methods* Electrocardiography / methods* Female Heart Conduction System / surgery* Humans Male Middle Aged Prognosis Pulmonary Veins / surgery* Reproducibility of Results Sensitivity and Specificity Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Electrophysiological differences of the spontaneous onset of paroxysmal and persistent atrial fibril...
Next Document: Impact of varying ablation patterns in a simulation model of persistent atrial fibrillation.