Dataset Information

P-Wave Beat-to-Beat Analysis to Predict Atrial Fibrillation Recurrence after Catheter Ablation.

ABSTRACT: The identification of patients prone to atrial fibrillation (AF) relapse after catheter ablation is essential for better patient selection and risk stratification. The current prospective cohort study aims to validate a novel P-wave index based on beat-to-beat (B2B) P-wave morphological and wavelet analysis designed to detect patients with low burden AF as a predictor of AF recurrence within a year after successful catheter ablation. From a total of 138 consecutive patients scheduled for AF ablation, 12-lead ECG and 10 min vectorcardiogram (VCG) recordings were obtained. Univariate analysis revealed that patients with higher B2B P-wave index had a two-fold risk for AF recurrence (HR: 2.35, 95% CI: 1.24-4.44, p: 0.010), along with prolonged P-wave, interatrial block, early AF recurrence, female gender, heart failure history, previous stroke, and CHA₂DS₂-VASc score. Multivariate analysis of assessable predictors before ablation revealed that B2B P-wave index, along with heart failure history and a history of previous stroke or transient ischemic attack, are independent predicting factors of atrial fibrillation recurrence. Further studies are needed to assess the predictive value of the B2B index with greater accuracy and evaluate a possible relationship with atrial substrate analysis.

SUBMITTER: Tachmatzidis D

PROVIDER: S-EPMC9028701 | biostudies-literature | 2022 Mar

REPOSITORIES: biostudies-literature

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P-Wave Beat-to-Beat Analysis to Predict Atrial Fibrillation Recurrence after Catheter Ablation.

Tachmatzidis Dimitrios D Tsarouchas Anastasios A Mouselimis Dimitrios D Filos Dimitrios D Antoniadis Antonios P AP Lysitsas Dimitrios N DN Mezilis Nikolaos N Sakellaropoulou Antigoni A Giannopoulos Georgios G Bakogiannis Constantinos C Triantafyllou Konstantinos K Fragakis Nikolaos N Letsas Konstantinos P KP Asvestas Dimitrios D Efremidis Michael M Lazaridis Charalampos C Chouvarda Ioanna I Vassilikos Vassilios P VP

Diagnostics (Basel, Switzerland) 20220328 4

The identification of patients prone to atrial fibrillation (AF) relapse after catheter ablation is essential for better patient selection and risk stratification. The current prospective cohort study aims to validate a novel P-wave index based on beat-to-beat (B2B) P-wave morphological and wavelet analysis designed to detect patients with low burden AF as a predictor of AF recurrence within a year after successful catheter ablation. From a total of 138 consecutive patients scheduled for AF abla ...[more]

PMID: 35453877

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Project description:ObjectiveThe objective of this study is to assess the predictive utility of perioperative P-wave parameters in patients with paroxysmal atrial fibrillation (PAF) undergoing catheter ablation, and to develop a predictive model using these parameters.MethodsA total of 213 patients with PAF undergoing catheter ablation were retrospectively analyzed. P-wave parameters were measured within 3 days preoperatively and on the day postoperatively to determine their predictive significance for postoperative PAF recurrence.ResultsPost-ablation, PAF did not recur in 168 patients, while 45 experienced recurrence. Significant differences were observed in preoperative P-wave parameters as Maximum P Wave Duration(Pmax), absolute value of P Wave Terminal Force of V1 (PtfV1) and P Wave Dispersion(Pd), postoperative P-wave parameters as P Wave Duration (PWDII, III, aVF), Pmax, P Wave Area(P-area), absolute value of PtfV1 and Pd, and changes in perioperative P-wave parameters (Delta-Pmax, Delta-PtfV1 absolute value, Delta-Pd, Delta-PWDII, III, aVF). Univariate logistic regression, receiver operating characteristic (ROC) curve analysis, and hazard ratio assessment identified predictive indicators for postoperative recurrence, including Pmax, PtfV1 absolute value, Pd, post-P area, post-PWDII, III, aVF and Delta-pwdII, III, aVF). A personalized nomogram model based on these P-wave parameters was developed. Calibration curve assessment demonstrated that the predictive performance of the nomogram for PAF recurrence following catheter ablation closely matched actual observed outcomes. ROC curve analysis indicated a sensitivity of 89.3% for the model, and decision curve analysis confirmed its significantly favorable predictive use and clinical benefits.ConclusionsP-wave parameters like PWDШ, PWDaVF, Pmax, Pd, and PtfV1 serve as predictors of PAF recurrence following catheter ablation. The nomogram model constructed using these P-wave parameters demonstrates robust predictive performance.

Dataset Information

P-Wave Beat-to-Beat Analysis to Predict Atrial Fibrillation Recurrence after Catheter Ablation.

Publications

P-Wave Beat-to-Beat Analysis to Predict Atrial Fibrillation Recurrence after Catheter Ablation.

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