The effect of high-power short-duration pulmonary vein isolation on PWPT-a predictor of paroxysmal atrial fibrillation.

IF 1.1 4区医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS Herz Pub Date : 2024-02-01 Epub Date: 2023-07-25 DOI:10.1007/s00059-023-05198-y

Meng Wang, Xiaochen Wang, Feng Gao, Pei Bao, Zheng Huang

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Abstract

Background: The P wave peak time (PWPT) is a predictor of paroxysmal atrial fibrillation (PAF). High-power short-duration ablation has been associated with improved durability of circumferential pulmonary vein electrical isolation (PVI). We investigated the effect of high-power short-duration PVI on PWPT in patients with PAF.

Methods: Out of 111 patients with PAF, 91 received radiofrequency ablation (ablation group) and 20 received medication treatment (control group). A VIZIGO sheath and an STSF catheter (Biosense Webster, CA, USA) were used together for high-power short-duration circumferential PVI at ablation index values of 500 and 400 for the anterior and posterior walls, respectively. The patients were followed up for 12 months.

Results: The preoperative PWPT in the ablation group was similar to that in the control group: PWPT II = 54.38 ± 6.18 ms vs. 54.35 ± 6.12 ms (p > 0.05), PWPT V₁ = 54.19 ± 6.21 ms vs. 54.31 ± 6.08 ms (p > 0.05), respectively. Circumferential PVI was achieved for all patients in the ablation group during the operation. At the 12-month follow-up, there were seven cases of AF recurrence. The PWPT in the ablation group 12 months postoperatively was shorter than the preoperative value: PWPT II = 49.39 ± 7.11 ms vs. 54.38 ± 6.18 ms (p < 0.001), PWPT V₁ = 47.69 ± 7.01 ms vs. 54.19 ± 6.21 ms (p < 0.001). The PWPT in the patients with AF recurrence was significantly longer than that in the non-recurrence patients: PWPT II = 50.48 ± 7.12 ms vs. 47.33 ± 6.21 ms (p < 0.001), PWPT V₁ = 50.84 ± 7.05 ms vs. 47.19 ± 6.27 ms, (p < 0.001). The PWPT of the control group at the 12-month follow-up was similar to the baseline level: PWPT II = 54.32 ± 6.20 ms vs. 54.35 ± 6.12 ms (p > 0.05), PWPT V₁ = 53.89 ± 6.01 ms vs. 54.31 ± 6.08 ms (p > 0.05).

Conclusion: The results showed that high-power short-duration PVI had a positive effect on PWPT, which is a predictor of PAF.

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高功率短时肺静脉隔离对 PWPT 的影响--这是阵发性心房颤动的预测指标。

背景：P 波峰值时间（PWPT）是阵发性心房颤动（PAF）的预测指标。高功率短时消融与改善环行肺静脉电隔离（PVI）的耐久性有关。我们研究了高功率短时程 PVI 对 PAF 患者 PWPT 的影响：在 111 名 PAF 患者中，91 人接受了射频消融治疗（消融组），20 人接受了药物治疗（对照组）。同时使用 VIZIGO 鞘和 STSF 导管（Biosense Webster，加利福尼亚州，美国）进行高功率短时周向 PVI，前壁和后壁的消融指数值分别为 500 和 400。对患者进行了 12 个月的随访：结果：消融组患者术前的脉搏波速度与对照组相似：PWPT II = 54.38 ± 6.18 ms vs. 54.35 ± 6.12 ms（P > 0.05），PWPT V1 = 54.19 ± 6.21 ms vs. 54.31 ± 6.08 ms（P > 0.05）。消融组所有患者在手术中均实现了环周 PVI。在 12 个月的随访中，有 7 例房颤复发。消融组患者术后 12 个月的 PWPT 短于术前值：PWPT II = 49.39 ± 7.11 ms vs. 54.38 ± 6.18 ms (p 1 = 47.69 ± 7.01 ms vs. 54.19 ± 6.21 ms (p 1 = 50.84 ± 7.05 ms vs. 47.19 ± 6.27 ms, (p 0.05)，PWPT V1 = 53.89 ± 6.01 ms vs. 54.31 ± 6.08 ms (p > 0.05)：结果表明，高功率短时 PVI 对 PWPT 有积极影响，而 PWPT 是 PAF 的预测指标。

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来源期刊

Herz 医学-心血管系统

CiteScore

3.00

自引率

5.90%

发文量

审稿时长

4-8 weeks

期刊介绍： Herz is the high-level journal for further education for all physicians interested in cardiology. The individual issues of the journal each deal with specific topics and comprise review articles in English and German written by competent and esteemed authors. They provide up-to-date and comprehensive information concerning the speciality dealt with in the issue. Due to the fact that all relevant aspects of the pertinent topic of an issue are considered, an overview of the current status and progress in cardiology is presented. Reviews and original articles round off the spectrum of information provided.