P Wave Morphology and Recurrence After Cardioversion of Lone Atrial Fibrillation

García, Ana Martín; Jiménez‐Candil, Javier; Hernández, Jesús M.; García, Agustín Martín; Herrero, Francisco Javier de Santiago; Luengo, Cándido Martín

doi:10.1016/j.rec.2011.04.020

Cited by 7 publications

(6 citation statements)

References 6 publications

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“…PtfV1 abnormalities can be caused by an enlarged left atrium, backward transfer of the left atrium, limitation of left atrial conduction velocity, and left atrial hypertrophy due to hemodynamic pressure. According to the study by Martín et al [ 17 ], the OR value of recurrent atrial fibrillation was 1.9 when the negative terminal of lead V1 decreased more than 0.1 mV and maintained 40 m. In order to avoid the error caused by ECG itself or the small value of PtfV1, PtfV1 ≥ 0.04 mV·s was set as the cutoff value in the present study, and its measurement was convenient with good analytic effect. The area under the ROC curve was measured based on PtfV1 ≥ 0.04 mV·s by ROC curve analysis of predictive ability, suggesting a high value of predicting recurrence after catheter ablation of atrial fibrillation.…”

Section: Discussionmentioning

confidence: 97%

Effectiveness of P-wave ECG index and left atrial appendage volume in predicting atrial fibrillation recurrence after first radiofrequency catheter ablation

Yang

Jia

et al. 2021

BMC Cardiovasc Disord

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Background The primary aim was to observe the predictive value of P-wave ECG index and left atrial appendage volume (LLAV) for atrial fibrillation recurrence after first radiofrequency catheter ablation. Methods A total of 196 patients with paroxysmal atrial fibrillation were enrolled. The preoperative LLAV was measured by cardiac enhanced CT. The P-wave ECG index including minimum P-wave duration (P-min), maximum P-wave duration (P-max), mean P-wave duration (mPWD), P-wave dispersion (PWD), P-wave terminal force in lead V1 (PtfV1), PR interval prolongation, and interatrial block (IAB) were analyzed and recorded in 12-lead ECG of sinus rhythm. Results According to the follow-up results, the patients were divided into two groups: the non-recurrence group and the recurrence group. P-min, PWD, P-max, PtfV1 ≥ 0.04 mV·s, PR interval prolongation, and the ratio of first and third-degree IAB in the recurrence group were higher than those in the non-recurrence group, with significant statistical differences (P < 0.05). Kaplan–Meier curve analysis was performed on time to atrial fibrillation recurrence after catheter ablation when PtfV1 ≥ 0.04 mv s by comparison between groups (Log Rank test: 2 = 4.739, P < 0.001). Kaplan–Meier curve analysis showed that the survival rate without recurrence of atrial fibrillation after catheter ablation was lower when the LLAV exceeded 8.0 mL (log-rank test P < 0.001). Conclusion PWD, P-max, PtfV1, PR interval prolongation, first and third-degree IAB, and LLAV can effectively predict atrial fibrillation recurrence after radiofrequency catheter ablation. The combination might be a valid and alternative independent predictor of recurrence.

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Section: Discussionmentioning

confidence: 97%

Effectiveness of P-wave ECG index and left atrial appendage volume in predicting atrial fibrillation recurrence after first radiofrequency catheter ablation

Yang

Jia

et al. 2021

BMC Cardiovasc Disord

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“…Finally, Martin Garcia et al. found that the recurrence of postcardioversion AF was higher in patients with a negative terminal deflection of the p‐wave in V1 > 40 ms, a finding that correlated with LA enlargement .…”

Section: Discussionmentioning

confidence: 97%

Advanced Interatrial Block is Associated with Recurrence of Atrial Fibrillation Post Pharmacological Cardioversion

Enríquez

Conde

Hopman

et al. 2014

Cardiovascular Therapeutics

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SUMMARYIntroduction: Management of atrial fibrillation (AF) is hampered by frequent recurrences after restoration of sinus rhythm. Delayed interatrial conduction has been associated with the development of AF in different clinical settings. The aim of our study was to assess whether advanced interatrial block (aIAB) was associated with AF recurrence after pharmacological cardioversion with two different antiarrhythmic drugs. Methods: We included 61 patients with recent onset AF without structural heart disease that underwent successful pharmacological cardioversion. Thirty-one patients received a single oral dose of propafenone, and 30 patients received iv vernakalant. A 12-lead ECG (filter 150 Hz, 25 mm/s, 10 mm/mV) after conversion was evaluated for the presence of interatrial block (IAB); partial (pIAB): P-wave duration > 120 ms, and advanced (aIAB): P-wave > 120 ms and biphasic morphology (AE) in inferior leads. Clinical follow-up and electrocardiographic recordings were performed for a 12-month period. Results: Age was 58 AE 10.4 years and 50.8% were male. aIAB was present in 11 patients (18%) and pIAB in 10 (16.4%). At 1-year follow-up, 22 patients (36%) had AF recurrence. The recurrence rate with aIAB was 90.9% versus 70% in those with pIAB and 12.5% in normal P-wave duration (P = 0.001). The presence of aIAB was strongly associated with AF recurrence (odds ratio 18.4 in multivariable modeling). Recurrence was not affected by the drug used for cardioversion (P = 0.92). Conclusion: Advanced interatrial block is associated with higher risk of AF recurrence at 1 year after pharmacological cardioversion, independent of the drug used.

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“…reported that abnormal Ptf is suggested as an indicator of atrial structural remodeling shown to be predictive of AF relapse following electrical cardioversion. [ 13 ] Furthermore, Yagmur et al . applied tissue Doppler imaging to patients with moderate-to-severe OSA, and found prolonged interatrial and intraatrial electromechanical delay, as well as P-wave dispersion.…”

Section: Discussionmentioning

confidence: 99%

Interatrial Conduction Block in an Obstructive Sleep Apnea Patient

Antonopoulos

2021

Heart Views

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Obstructive sleep apnea (OSA) is an important sleep disorder and is associated with increased cardiovascular morbidity and mortality. Several recent studies have demonstrated an association OSA and atrial fibrillation (AF). Therefore, it is of great importance understanding the pathophysiological substrate and the interaction between OSA and AF. Moreover, it is well accepted that interatrial block (IAB), evaluated not only by the P-wave duration but also by the P-wave morphology, has the potential to give information about the anatomical substrate predisposing to AF. OSA and AF share many risk factors and comorbidities, including older age, male gender, obesity, hypertension, heart failure, and coronary artery diseases. IAB is defined when the P-wave is ≥120 ms which signifies excessive time for sinus impulses to conduct from the right atrium to the left atrium and may predict future AF events. Accordingly, recent studies have suggested that OSA is associated with atrial functional and structural remodeling which indeed are associated with increased risk of AF. We speculate that IAB, a known factor to predict future AF episodes, may associate with OSA and contribute to the development of arrhythmic events. In the present case, the report presents a woman with OSA and IAB on the surface electrocardiogram (ECG)automatic P-wave analysis and some short episodes of AF in the external event recorder monitoring.

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P Wave Morphology and Recurrence After Cardioversion of Lone Atrial Fibrillation

Cited by 7 publications

References 6 publications

Effectiveness of P-wave ECG index and left atrial appendage volume in predicting atrial fibrillation recurrence after first radiofrequency catheter ablation

Effectiveness of P-wave ECG index and left atrial appendage volume in predicting atrial fibrillation recurrence after first radiofrequency catheter ablation

Advanced Interatrial Block is Associated with Recurrence of Atrial Fibrillation Post Pharmacological Cardioversion

Interatrial Conduction Block in an Obstructive Sleep Apnea Patient

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