Low P-wave amplitude (˂0.1 mV) in lead I is associated with displaced inter-atrial conduction and clinical recurrence of paroxysmal atrial fibrillation after radiofrequency catheter ablation
- Authors
- Park, Jin Kyu; Park, Junbeom; Uhm, Jae-Sun; Joung, Boyoung; Lee, Moon-Hyoung; Pak, Hui-Nam
- Issue Date
- May-2015
- Publisher
- OXFORD UNIV PRESS
- Keywords
- P-wave; Paroxysmal atrial fibrillation; Catheter ablation; Recurrence; Inter-atrial conduction
- Citation
- EUROPACE, v.18, no.3, pp.384 - 391
- Indexed
- SCIE
SCOPUS
- Journal Title
- EUROPACE
- Volume
- 18
- Number
- 3
- Start Page
- 384
- End Page
- 391
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/157201
- DOI
- 10.1093/europace/euv028
- ISSN
- 1099-5129
- Abstract
- Aims We hypothesized that P-wave amplitude in lead I is related to left atrial (LA) remodelling and inter-atrial conduction pattern, and has a predictive value for recurrence after radiofrequency catheter ablation (RFCA) among patients with paroxysmal atrial fibrillation (PAF). Methods and results A total of 525 consecutive patients with PAF (76% male, 56 ± 12 years old) who underwent RFCA were included. We compared pre-procedural sinus rhythm electrocardiograms without antiarrhythmic drug effect with LA volume (CT), LA voltage (NavX), the earliest activation site (EAS) conduction pattern of LA, and clinical recurrence rate. P-wave amplitude in lead I was significantly lower in patients with recurrence than in those that remained in sinus rhythm (P < 0.001) during 21 ± 10-month follow-up. P-wave amplitude in lead I was linearly correlated with LA voltage (β = 2.52, 95% CI 0.606-4.425, P = 0.010), LA conduction velocity (β = 1.91, 95% CI 0.941-2.876, P < 0.001), and low septal displacement of EAS (β = -1.67, 95% CI -2.352 to -0.996, P < 0.001). P-wave amplitudes <0.1 mV in lead I were independently associated with clinical recurrence of AF on multivariate Cox regression analysis (adjusted HR 2.163, 95% CI 1.307-3.581, P = 0.003). The integrated area under the curves was 0.705 (95% CI 0.655-0.755). Conclusion Low P-wave amplitude (<0.1 mV) in lead I is related to LA remodelling and displaced inter-atrial conduction pattern to low septum, and independently predicts clinical recurrence after RFCA in patients with PAF.
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