The Value of P‐Wave Parameters Changes in Predicting Catheter Ablation Outcomes for Paroxysmal Atrial Fibrillation
ABSTRACT Background Pulmonary vein isolation (PVI) is the most promising management method for paroxysmal atrial fibrillation (PAF). The P wave in the electrocardiogram (ECG) represents atrial depolarization. This study aims to correlate P‐wave parameters after PVI with outcomes. Methods This single...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | Annals of Noninvasive Electrocardiology |
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| Online Access: | https://doi.org/10.1111/anec.70047 |
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| author | Ibrahim Antoun Xin Li Zakariyya Vali Ahmed Kotb Ahmed Abdelrazik Ivelin Koev Riyaz Somani G. André Ng |
| author_facet | Ibrahim Antoun Xin Li Zakariyya Vali Ahmed Kotb Ahmed Abdelrazik Ivelin Koev Riyaz Somani G. André Ng |
| author_sort | Ibrahim Antoun |
| collection | DOAJ |
| description | ABSTRACT Background Pulmonary vein isolation (PVI) is the most promising management method for paroxysmal atrial fibrillation (PAF). The P wave in the electrocardiogram (ECG) represents atrial depolarization. This study aims to correlate P‐wave parameters after PVI with outcomes. Methods This single‐center retrospective study included consecutive patients with first‐time PVI for PAF between 2018 and 2019 and targeted pulmonary veins (PVs). Procedure success was defined by freedom of ECG‐documented AF at 12 months. Digital 12 leads ECGs with 1–50 hertz bandpass filter were monitored before the procedure. P‐wave amplitude (PWA) and P‐wave terminal force in V1 (PTFV1) Corrected P‐wave duration (PWDc), and P‐wave dispersion (PWDisp), were measured before and after ablation. Results The final analysis included 180 patients, of which 130 (72%) had successful ablations and 53 (30%) had radiofrequency ablation (RF). Males comprised 71% of the patients; the mean age was 60. Demographics were similar between both arms p < 0.001. Patients with failed PVI had increased PWDc after PVI (139–146 ms, p < 0.001) compared to patients with successful PVI. PWA increased significantly after failed PVI (1.6–2 mV, p < 0.001) and successful PVI (1.6–1.8 mV, p = 0.008). PWD (hazard ratio [HR]: 2.5, 95% confidence interval [CI]: 1.4–4.2, p < 0.001) and PWA (HR: 1.7, 95% CI: 1.2–2.9, p = 0.03) were independently associated with PVI failure at 12 months. PWdisp and PTFV1 were not correlated with outcomes. Conclusion Increased PWDc and PWA after PVI were independently associated with failed ablation for PAF, supporting the role of P‐wave parameters in predicting outcomes. |
| format | Article |
| id | doaj-art-a4781ae2834040b3be2c79dafc1325a4 |
| institution | Kabale University |
| issn | 1082-720X 1542-474X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
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| series | Annals of Noninvasive Electrocardiology |
| spelling | doaj-art-a4781ae2834040b3be2c79dafc1325a42025-01-28T05:38:41ZengWileyAnnals of Noninvasive Electrocardiology1082-720X1542-474X2025-01-01301n/an/a10.1111/anec.70047The Value of P‐Wave Parameters Changes in Predicting Catheter Ablation Outcomes for Paroxysmal Atrial FibrillationIbrahim Antoun0Xin Li1Zakariyya Vali2Ahmed Kotb3Ahmed Abdelrazik4Ivelin Koev5Riyaz Somani6G. André Ng7Department of Cardiology, University Hospitals of Leicester NHS Trust Glenfield Hospital Leicester UKDepartment of Engineering University of Leicester Leicester UKDepartment of Cardiology, University Hospitals of Leicester NHS Trust Glenfield Hospital Leicester UKDepartment of Cardiovascular Sciences, Clinical Science Wing University of Leicester Leicester UKDepartment of Cardiology, University Hospitals of Leicester NHS Trust Glenfield Hospital Leicester UKDepartment of Cardiology, University Hospitals of Leicester NHS Trust Glenfield Hospital Leicester UKDepartment of Cardiology, University Hospitals of Leicester NHS Trust Glenfield Hospital Leicester UKDepartment of Cardiology, University Hospitals of Leicester NHS Trust Glenfield Hospital Leicester UKABSTRACT Background Pulmonary vein isolation (PVI) is the most promising management method for paroxysmal atrial fibrillation (PAF). The P wave in the electrocardiogram (ECG) represents atrial depolarization. This study aims to correlate P‐wave parameters after PVI with outcomes. Methods This single‐center retrospective study included consecutive patients with first‐time PVI for PAF between 2018 and 2019 and targeted pulmonary veins (PVs). Procedure success was defined by freedom of ECG‐documented AF at 12 months. Digital 12 leads ECGs with 1–50 hertz bandpass filter were monitored before the procedure. P‐wave amplitude (PWA) and P‐wave terminal force in V1 (PTFV1) Corrected P‐wave duration (PWDc), and P‐wave dispersion (PWDisp), were measured before and after ablation. Results The final analysis included 180 patients, of which 130 (72%) had successful ablations and 53 (30%) had radiofrequency ablation (RF). Males comprised 71% of the patients; the mean age was 60. Demographics were similar between both arms p < 0.001. Patients with failed PVI had increased PWDc after PVI (139–146 ms, p < 0.001) compared to patients with successful PVI. PWA increased significantly after failed PVI (1.6–2 mV, p < 0.001) and successful PVI (1.6–1.8 mV, p = 0.008). PWD (hazard ratio [HR]: 2.5, 95% confidence interval [CI]: 1.4–4.2, p < 0.001) and PWA (HR: 1.7, 95% CI: 1.2–2.9, p = 0.03) were independently associated with PVI failure at 12 months. PWdisp and PTFV1 were not correlated with outcomes. Conclusion Increased PWDc and PWA after PVI were independently associated with failed ablation for PAF, supporting the role of P‐wave parameters in predicting outcomes.https://doi.org/10.1111/anec.70047atrial fibrillationcatheter ablationP‐waveP‐wave amplitudeP‐wave duration |
| spellingShingle | Ibrahim Antoun Xin Li Zakariyya Vali Ahmed Kotb Ahmed Abdelrazik Ivelin Koev Riyaz Somani G. André Ng The Value of P‐Wave Parameters Changes in Predicting Catheter Ablation Outcomes for Paroxysmal Atrial Fibrillation Annals of Noninvasive Electrocardiology atrial fibrillation catheter ablation P‐wave P‐wave amplitude P‐wave duration |
| title | The Value of P‐Wave Parameters Changes in Predicting Catheter Ablation Outcomes for Paroxysmal Atrial Fibrillation |
| title_full | The Value of P‐Wave Parameters Changes in Predicting Catheter Ablation Outcomes for Paroxysmal Atrial Fibrillation |
| title_fullStr | The Value of P‐Wave Parameters Changes in Predicting Catheter Ablation Outcomes for Paroxysmal Atrial Fibrillation |
| title_full_unstemmed | The Value of P‐Wave Parameters Changes in Predicting Catheter Ablation Outcomes for Paroxysmal Atrial Fibrillation |
| title_short | The Value of P‐Wave Parameters Changes in Predicting Catheter Ablation Outcomes for Paroxysmal Atrial Fibrillation |
| title_sort | value of p wave parameters changes in predicting catheter ablation outcomes for paroxysmal atrial fibrillation |
| topic | atrial fibrillation catheter ablation P‐wave P‐wave amplitude P‐wave duration |
| url | https://doi.org/10.1111/anec.70047 |
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