The Role of P Wave Parameters in Predicting Pulmonary Vein Isolation Outcomes for Paroxysmal Atrial Fibrillation: An Observational Cohort Study.

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-09-05 DOI:10.3390/jcdd11090277

Ibrahim Antoun, Xin Li, Ahmed I Kotb, Zakkariya Vali, Ahmed Abdelrazik, Abdulmalik Koya, Akash Mavilakandy, Ivelin Koev, Ali Nizam, Hany Eldeeb, Riyaz Somani, André Ng

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Abstract

Background: Pulmonary vein isolation (PVI) is an effective management method for paroxysmal atrial fibrillation (PAF). The P wave in the 12-lead electrocardiogram (ECG) represents atrial depolarisation. This study aims to utilise the P wave to predict PVI outcomes for PAF.

Methods: This single-centre retrospective study aimed to predict PVI outcomes using P wave parameters. It included 211 consecutive patients with first PVI for PAF between 2018 and 2019 and targeted the pulmonary veins (PVs). Procedure success was defined by freedom of ECG-documented AF at 12 months. Digital 12-lead ECGs with 1-50 hertz bandpass filters were monitored before the procedure. Corrected P wave duration (PWDc), P wave amplitude (PWV), P wave dispersion (PWDisp), intra-atrial block (IAB), P wave area (PWA), and P wave terminal force in V1 (PTFV1) were measured before ablation and correlated with the outcomes.

Results: Successful PVI occurred in 154 patients (73%). Demographics were similar between both arms. P wave parameters correlated with PVI failure included increased PWDc in all leads except for lead III, aVR, and V3, decreased PWV in lead I (hazard ratio [HR]: 0.7, 95% confidence interval [CI]: 0.53-0.95), lead II (HR: 0.45, 95% CI: 0.22-0.65), aVL (HR: 0.58, 95% CI: 0.22-0.98), and aVF (HR: 0.67, 95% CI: 0.58-0.87), decreased PWA in lead I (HR: 0.55, 95% CI: 0.21-0.76), lead II (HR: 0.48, 95% CI: 0.34-0.87), aVL (HR: 0.65, 95% CI: 0.45-0.96), and aVF (HR: 0.61, 95% CI: 0.32-0.89), and the presence of IAB (HR: 2, 95% CI: 1.4-4.2, p = 0.02). PWDisp and PTFV1 were not correlated with PVI outcome.

Conclusions: PWDc, PWA, PWV, and IAB are valuable predictors for PVI outcome for PAF at 12 months.

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P 波参数在预测阵发性心房颤动肺静脉隔离术结果中的作用：一项观察性队列研究

背景：肺静脉隔离（PVI）是治疗阵发性心房颤动（PAF）的有效方法。12 导联心电图（ECG）中的 P 波代表心房去极化。本研究旨在利用 P 波预测 PAF 的 PVI 治疗效果：这项单中心回顾性研究旨在利用 P 波参数预测 PVI 的预后。研究纳入了 2018 年至 2019 年间首次进行 PVI 治疗 PAF 的 211 例连续患者，以肺静脉（PV）为目标。手术成功的定义是 12 个月内无心电图记录的房颤。术前使用 1-50 赫兹带通滤波器监测数字 12 导联心电图。消融前测量了校正 P 波持续时间（PWDc）、P 波振幅（PWV）、P 波弥散（PWDisp）、房内阻滞（IAB）、P 波面积（PWA）和 V1 中的 P 波末端力（PTFV1），并将其与结果相关联：结果：154 名患者（73%）成功实施了 PVI。两组患者的人口统计学特征相似。与 PVI 失败相关的 P 波参数包括：除导联 III、aVR 和 V3 外，所有导联的 PWDc 均增大；导联 I 的 PWV 均减小（危险比 [HR]：0.7，95% 置信区间 [CI]：0.53-0.95）；导联 II（HR：0.45，95% CI：0.22-0.65）；aVL（HR：0.58，95% CI：0.22-0.98）和 aVF（HR：0.67，95% CI：0.58-0.87），I 导联（HR：0.55，95% CI：0.21-0.76）、II 导联（HR：0.48，95% CI：0.34-0.87）、aVL（HR：0.65，95% CI：0.45-0.96）和 aVF（HR：0.61，95% CI：0.32-0.89），以及存在 IAB（HR：2，95% CI：1.4-4.2，P = 0.02）。PWDisp和PTFV1与PVI结果无关：结论：PWDc、PWA、脉搏波速度和 IAB 是预测 PAF 12 个月后 PVI 结果的重要指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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