ISSN 1016-5169 | E-ISSN 1308-4488
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An Effective Novel Index for Predicting the Recurrence of Atrial Fibrillation Ablation: P Wave Duration-to-Amplitude Ratio [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2022; 50(7): 498-504 | DOI: 10.5543/tkda.2022.22416

An Effective Novel Index for Predicting the Recurrence of Atrial Fibrillation Ablation: P Wave Duration-to-Amplitude Ratio

Mustafa Doğduş1, Oğuzhan Ekrem Turan2, Ahmet Anıl Başkurt3, Reşit Yigit Yılancıoğlu4, Ufuk Özgül5, Umut Dursun Inevi6, Emin Evren Özcan2
1Department of Cardiology, Uşak University Training and Research Hospital, Uşak, Turkey
2Heart Rhythm Management Center, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
3Department of Cardiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
4Department of Cardiology, Bornova Türkan Özilhan State Hospital, İzmir, Turkey
5Department of Cardiology, Aydın Atatürk State Hospital, Aydın, Turkey
6Ege Aritmi Medical Products Engineering, İzmir, Turkey


OBJECTIVE
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-t o-amplitude ratio in predicting the recurrence of atrial fibrillation.


METHODS
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.


RESULTS
While P wave duration (129 ± 18.4 vs. 109 ± 15.7 ms, P <.001), P wave duration-to-amplitude 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 ratio value 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).


CONCLUSION
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.

Keywords: Atrial fi, brillation ablation, P wave amplitude, P wave duration, recurrence

How to cite this article
Mustafa Doğduş, Oğuzhan Ekrem Turan, Ahmet Anıl Başkurt, Reşit Yigit Yılancıoğlu, Ufuk Özgül, Umut Dursun Inevi, Emin Evren Özcan. An Effective Novel Index for Predicting the Recurrence of Atrial Fibrillation Ablation: P Wave Duration-to-Amplitude Ratio. Turk Kardiyol Dern Ars. 2022; 50(7): 498-504

Corresponding Author: Mustafa Doğduş
Manuscript Language: English


Journal Metrics

Journal Citation Indicator: 0.18
CiteScore: 1.1
Source Normalized Impact
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0.22
SCImago Journal Rank: 0.348

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