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

Jin Kyu Park, Junbeom Park, Jae Sun Uhm, Boyoung Joung, Moon Hyoung Lee, Hui Nam Pak

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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. Published on behalf of the European Society of Cardiology. All rights reserved.

Original languageEnglish
Pages (from-to)384-391
Number of pages8
JournalEuropace
Volume18
Issue number3
DOIs
Publication statusPublished - 2016 Mar 1

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Catheter Ablation
Atrial Fibrillation
Recurrence
Atrial Remodeling
Cone-Beam Computed Tomography
Anti-Arrhythmia Agents
Area Under Curve
Electrocardiography
Regression Analysis
Lead

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

@article{b9575e829f09440dba90edfd7fb221b1,
title = "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",
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. Published on behalf of the European Society of Cardiology. All rights reserved.",
author = "Park, {Jin Kyu} and Junbeom Park and Uhm, {Jae Sun} and Boyoung Joung and Lee, {Moon Hyoung} and Pak, {Hui Nam}",
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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. / Park, Jin Kyu; Park, Junbeom; Uhm, Jae Sun; Joung, Boyoung; Lee, Moon Hyoung; Pak, Hui Nam.

In: Europace, Vol. 18, No. 3, 01.03.2016, p. 384-391.

Research output: Contribution to journalArticle

TY - JOUR

T1 - 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

AU - Park, Jin Kyu

AU - Park, Junbeom

AU - Uhm, Jae Sun

AU - Joung, Boyoung

AU - Lee, Moon Hyoung

AU - Pak, Hui Nam

PY - 2016/3/1

Y1 - 2016/3/1

N2 - 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. Published on behalf of the European Society of Cardiology. All rights reserved.

AB - 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. Published on behalf of the European Society of Cardiology. All rights reserved.

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