Abstract 9142: Post Procedural Changes of P-wave Duration can Predict Recurrence of Atrial Fibrillation after Circumferential Pulmonary Vein Isolation

Abstract

Background: It has been reported that the significant shortening of P-wave duration after pulmonary vein isolation was related to successful outcome. However, the impact of the clinical outcomes after circumferential pulmonary vein isolation (CPVI) on the serial changes of P-wave characteristics is not clear. We hypothesized that the recurrence of atrial fibrillation (AF) prolonged P-wave duration and the recurrence of AF after CPVI affected the P-wave parameters by P-wave signal averaged electrocardiogram (P-SAECG). Methods: Fifty-nine patients (65±7years, 41 male) with AF (paroxysmal AF : n=44, persistent AF : n=15) who underwent CPVI alone and received P-SAECG at 2 days, 2 weeks, and 4weeks after CPVI were enrolled in this study. By using P-SAECG, the filtered P-wave duration (FPD) and root mean square voltage for the last 20msec (RMS20) were measured and the serial changes of FPD and RMS20 were calculated. AF recurrence was defined as patient's symptom and any episode of AF lasting > 30 seconds on surface 12-leads ECG or 24-hour Holter ECG during follow-up periods except for 2 months post CPVI. Results: The patients were followed for 6±3 months. The recurrences of AF occurred in 18 of 59 patients (31%). The results of P-SAECG parameters were shown as table. The FPD of 2 days, 2weeks and 4weeks after CPVI in AF recurrence group was significantly longer than that in sinus rhythm (SR) maintenance group and the ΔFPD 4weeks in AF recurrence group was significantly prolonged than that in SR maintenance group. Using FPD 4weeks as cutoff value of > 130.5 msec to predict AF recurrence, the sensitivity and specificity were 65% and 61%, respectively. Using ΔFPD 4weeks as cutoff value of > 3.5 msec to predict AF recurrence, the sensitivity and specificity were 71% and 63%, respectively. Conclusion: The longer FPD and prolongation of FPD for one month after CPVI can predict the recurrence of AF after CPVI.