Tachmatzidis Dimitrios, Tsarouchas Anastasios, Mouselimis Dimitrios, Filos Dimitrios, Antoniadis Antonios P, Lysitsas Dimitrios N, Mezilis Nikolaos, Sakellaropoulou Antigoni, Giannopoulos Georgios, Bakogiannis Constantinos, Triantafyllou Konstantinos, Fragakis Nikolaos, Letsas Konstantinos P, Asvestas Dimitrios, Efremidis Michael, Lazaridis Charalampos, Chouvarda Ioanna, Vassilikos Vassilios P
3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece.
Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece.
Diagnostics (Basel). 2022 Mar 28;12(4):830. doi: 10.3390/diagnostics12040830.
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, : 0.010), along with prolonged P-wave, interatrial block, early AF recurrence, female gender, heart failure history, previous stroke, and CHADS-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.
识别导管消融术后易发生心房颤动（AF）复发的患者对于更好地进行患者选择和风险分层至关重要。当前的前瞻性队列研究旨在验证一种基于逐搏（B2B）P波形态和小波分析的新型P波指数，该指数旨在检测低负荷AF患者，作为成功导管消融术后一年内AF复发的预测指标。从总共138例计划进行AF消融的连续患者中，获取了12导联心电图和10分钟向量心电图（VCG）记录。单因素分析显示，B2B P波指数较高的患者AF复发风险增加两倍（HR：2.35，95%CI：1.24 - 4.44，P = 0.010），同时伴有P波延长、房间阻滞、早期AF复发、女性、心力衰竭病史、既往卒中以及CHADS - VASc评分。消融术前可评估预测因素的多因素分析显示，B2B P波指数以及心力衰竭病史和既往卒中或短暂性脑缺血发作史是心房颤动复发的独立预测因素。需要进一步研究以更准确地评估B2B指数的预测价值，并评估其与心房基质分析的可能关系。
