Electrocardiographic left ventricular hypertrophy predicts recurrence of atrial arrhythmias after catheter ablation of paroxysmal atrial fibrillation with hypertension

Abstract

Objective To investigate whether left ventricular hypertrophy (LVH) or LVH with ST-T strain on electrocardiogram (ECG) can predict arrhythmia recurrence after radiofrequency catheter ablation (RFCA) in paroxysmal atrial fibrillation (PAF) patients with hypertension. Methods From January 2007 to May 2014, 280 PAF patients with hypertension undergoing RFCA in Beijing Anzhen Hospital were consecutively enrolled, and clustered into 3 groups based on the preoperational ECG findings: Non-LVH (140 patients) , ECG LVH (114 patients) , ECG LVH with ST-T Strain (26 patients) . The Romhilt-Estes point score≥5 points were defined as LVH. LVH with strain was defined as LVH and ST-segment depression≥0.1 mV with inverted asymmetric T wave≥0.1 mV opposite the QRS axis in the lateral leads in a resting ECG. Results After 42 (interquartile range, 24.0-66.0 months) months follow-up period post 1.19±0.46 times of RFCA procedures, 169 patients (61.9%) maintained sinus rhythm without using antiarrhythmic drugs, 104 (74.3%) in the non-LVH group, 55 (48.2%) in the LVH group, 10 (38.5%) in the LVH with strain group (P<0.001) . Multivariate analysis indicated ECG abnormalities including LVH and LVH with strain to be independent risk factors for recurrence after adjusting for confounding factors (HR=2.103, 95% CI 1.231-3.590; HR=2.621, 95% CI 1.238-5.550; respectively) . Conclusion The ECG abnormalities including LVH and LVH with strain were strong and independent predictors of recurrence present of in PAF patients with hypertension following RFCA. Key words: Atrial fibrillation; Left ventricular hypertrophy; Radiofrequency catheter ablation