Department of Cardiology, Uşak University Training and Research Hospital, Uşak, Turkey.
Heart Rhythm Management Center, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey.
Turk Kardiyol Dern Ars. 2022 Oct;50(7):498-504. doi: 10.5543/tkda.2022.22416.
Atrial fibrillation is the most common arrhythmia observed in the clinical practice. Pulmonary vein isolation is a well established treatment option for atrial fibrillation but is limited by recurrence. Previous studies have demonstrated that abnormal P wave indices were associated with adverse atrial remodeling and its role in predicting atrial fibrillation recurrence. In the present study, we aimed to evaluate the place of a novel index as we named P wave duration-to-amplitude ratio in predicting the recurrence of atrial fibrillation.
Patients who underwent pulmonary vein isolation for symptomatic drug-resistant atrial fibrillation between January 2016 and March 2018 were retrospectively screened. A total of 111 patients were enrolled in the current study. P wave indices of the patients were calculated by precisely measuring the electrocardiogram traces recorded with an electrophysiology recording system.
While P wave duration (129 ± 18.4 vs. 109 ± 15.7 ms, P <.001), P wave duration-toamplitude ratio (1072.7 ± 528.3 vs. 626.9 ± 368 ms/mV, P <.001), P wave peak time (65 ± 12 vs. 54 ± 10 ms, P <.001), and P wave dispersion (49 ± 14.1 vs. 27.9 ± 17 ms, P =.001) values were significantly higher in the atrial fibrillation recurrence (+) group, the P wave amplitude (0.12 ± 0.05 vs. 0.18 ± 0.02 mV, P <.001) value was found to be lower. A P wave duration-t o-amplitude ratiovalue of >830 ms/mV has 61.8% sensitivity and 88.4% specificity for the prediction of the atrial fibrillation recurrence (area of under the curve [AUC], 0.727).
P wave duration-to-amplitude ratio, which may be considered as an indicator of the temporal and electrical propagation of the P wave in the atria, can predict atrial fibrillation ablation recurrence.
心房颤动是临床实践中最常见的心律失常。肺静脉隔离是治疗心房颤动的一种成熟的治疗方法，但受到复发的限制。先前的研究表明，异常的 P 波指数与不良的心房重构及其在预测心房颤动复发中的作用有关。在本研究中，我们旨在评估一种新的指数（我们命名为 P 波时间-振幅比）在预测心房颤动复发中的作用。
回顾性筛选了 2016 年 1 月至 2018 年 3 月期间因症状性药物抵抗性心房颤动而行肺静脉隔离的患者。共有 111 例患者被纳入本研究。通过精确测量电生理记录系统记录的心电图迹线来计算患者的 P 波指数。
在心房颤动复发（+）组中，P 波持续时间（129±18.4 比 109±15.7ms，P <.001）、P 波时间-振幅比（1072.7±528.3 比 626.9±368ms/mV，P <.001）、P 波峰值时间（65±12 比 54±10ms，P <.001）和 P 波离散度（49±14.1 比 27.9±17ms，P=.001）值显著升高，而 P 波振幅（0.12±0.05 比 0.18±0.02mV，P <.001）值降低。P 波时间-振幅比值>830ms/mV 对心房颤动复发的预测具有 61.8%的敏感性和 88.4%的特异性（曲线下面积[AUC]，0.727）。
P 波时间-振幅比可作为心房内 P 波时程和电传播的指标，可预测心房颤动消融复发。
