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An ECG Index of P‐Wave Force Predicts the Recurrence of Atrial Fibrillation after Pulmonary Vein Isolation
Author(s) -
KANZAKI YASUNORI,
INDEN YASUYA,
ANDO MONAMI,
KAMIKUBO YOSUKE,
ITO TADAHIRO,
MIZUTANI YOSHIAKI,
KATO HIROYUKI,
FUJII AYA,
YANAGISAWA SATOSHI,
HIRAI MAKOTO,
MUROHARA TOYOAKI
Publication year - 2016
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12956
Subject(s) - medicine , pulmonary vein , atrial fibrillation , cardiology , ablation , paroxysmal atrial fibrillation , catheter ablation
Background Although several prognostic factors of atrial fibrillation (AF) recurrence after pulmonary vein isolation (PVI) have been investigated, the accurate prediction of AF recurrence remains difficult. We propose an electrocardiogram (ECG) index, the P‐wave force (PWF), which is the product of the amplitude of the negative terminal phase of the P wave in the V1 electrode and the filtered P‐wave duration, obtained by a signal‐averaged P‐wave analysis. This study was conducted to evaluate the impact of the PWF on the recurrence of AF after PVI. Methods We retrospectively evaluated 79 paroxysmal AF patients (64 ± 9 years, 56 males) who underwent PVI by cryoballoon ablation. Standard 12‐lead ECG and a P‐wave signal‐averaged electrocardiogram (SAECG) were recorded the day before and 1 month after the PVI procedure. Results During the mean follow‐up of 10.2 months, AF recurred in 11 (14%) patients. The PWF 1 month after ablation was significantly higher in the recurrence group compared to that in the nonrecurrence group (8.8 ± 3.1 mVms vs 6.5 ± 2.9 mVms, P = 0.017). The patients with a PWF value ≥9.3 mVms had a significantly greater risk of recurrence after the ablation compared to the patients with a PWF value <9.3 mVms (log‐rank test, P < 0.001). Conclusion Higher PWF after cryoballoon ablation was associated with poor prognosis during follow‐up. The PWF may be a useful and noninvasive marker to predict the recurrence of AF.