P‐Wave Abnormality Predicts Recurrence of Atrial Fibrillation after Electrical Cardioversion: A Prospective Study

Abstract

A prolonged P-wave duration measured by 12-lead ECG predicts recurrent AF within 1 month after ECV.

P-wave Variability and Atrial Fibrillation

“…Blanche et al found that none of the P-wave parameters was statistically different between patients with and patients without AF recurrences15; Gonna et al reported that parameters associated to P-wave duration were significantly greater in the recurrent AF than in the sinus rhythm group13. Both groups concluded that the measurement and use of atrial electrical heterogeneity indices need further research to find accurate and reliable risk factors for AF recurrences in patients with persistent AF.…”

Advanced Interatrial Block Predicts New Onset Atrial Fibrillation in Patients with Severe Heart Failure and Cardiac Resynchronization Therapy

“…17,18 The delayed and heterogeneous activation of the LA results in dispersion of atrial refractory periods, interatrial dyssynchrony and impaired LA mechanical function, 19,20 all of which favor the development of AF. Thus, IAB (partial or advanced) has been found to be associated with new-onset AF in patients from a general hospital population, 21 , recurrence of AF postelectrical or pharmacological cardioversion, 22,23 , AF recurrence after pulmonary vein isolation, 24 and progression of paroxysmal AF to the persistent or permanent forms of the disease. 25,26 In patients with CHF, the association of Pwave abnormalities with development of AF was first described by Yamada et al 15 using signal averaged ECG (SAECG).…”

P-Wave Duration or P-Wave Morphology? Interatrial Block: Seeking for the Holy Grail to Predict AF Recurrence

“…1 The authors evaluated a group of patients with persistent atrial fibrillation (AF) referred for electrical cardioversion. 1 The authors evaluated a group of patients with persistent atrial fibrillation (AF) referred for electrical cardioversion.…”

“…2,3 Delay and eventually block at the Bachman bundle level results not only in prolongation of the P-wave duration but also in the development of a final negative component of the P wave in the inferior leads. 5 One would like to know whether a morphological analysis in the interesting series of Gonna et al 1 may shed some light in understanding which patients with long P-wave duration are more prone to develop AF recurrence. 4 This negative component is a reflection of caudal-cranial activation of the left atrium that happens in cases of block at the Bachman level, as it was demonstrated by Bayés de Luna several years ago (Fig.…”