Impact of catheter ablation on P-wave parameters on 12-lead electrocardiogram in patients with atrial fibrillation

Abstract

BackgroundCatheter ablation has emerged as a widely used treatment modality for atrial fibrillation (AF). P-wave abnormalities have been described in the patients with AF, and catheter ablation may potentially further impact P-wave parameters due to ablation of atrial tissue. MethodsWe reviewed data on P-wave parameters (P-wave duration, amplitude and P-wave duration and amplitude product) in leads V1 and aVF and changes in the P-terminal force (Ptf; product of duration and amplitude of terminal part of P-wave) in lead V1 from 12-lead electrocardiograms obtained prior to and after CA of a total of 46 (28 paroxysmal and 18 persistent) AF patients. ResultsThe median age of patients in our study was 63 (range: 30–77) years. We noticed a significant reduction in the P-wave duration (from 87.39±28.62ms at baseline to 72.09±24.59ms; p=0.0072) and the product of P-wave duration and amplitude in lead V1 (12.16±5.54mVms at baseline to 8.30±5.78mVms, p=0.0015) after CA. There was also a significant decrease in P-wave duration (from 92.57±19.67ms at baseline to 76.48±16.32ms after CA, p=0.0001) and P-wave duration and amplitude product in lead aVF (12.61±4.05mVms at baseline to 9.77±3.86mVms after CA, p=0.0001). CA also led to a significant decrease in Ptf (from 4.56±1.88 at baseline to 2.85±1.42mVms, p<0.0001). ConclusionRadiofrequency catheter ablation of AF leads to modification of P-wave parameters with substantial diminution in both the amplitude and duration of the P-wave in leads V1 and aVF. This likely represents reduction in electrically active atrial tissue after ablation, and may serve as a marker for the extent of ablated atrial tissue.