M8. Electrocardiogram findings as predictor of atrial fibrillation recurrence after intervention: systematic review and meta-analysis

Abstract

Abstract Background Atrial fibrillation (AF) recurrence rate still stands between 40% and 50%, causing complications. Therefore, early diagnosis of AF recurrence is needed for prompt treatment, thus morbidity and mortality could be reduced and quality of life could be improved. Aim Determine predictive value of electrocardiogram and its findings towards AF recurrence in population who have underwent intervention. Methods Systematic review and meta-analysis was conducted according to PRISMA statement. Six reviewers searched studies from PubMed, ProQuest, ScienceDirect, and EBSCO from inception to June 2021 with primary outcome of AF recurrence. Data was appraised and processed using random effects or fixed effects model with the outcome of mean difference (MD) or odds ratio (OR) with 95%-confidence interval (95% CI). Results Thirty included studies involving 5,490 subjects were found good in terms of quality assessment. AF recurrence on patients underwent cardioversion was more likely found in patients with larger P-wave duration (OR = 2.90; 95% CI [1.47, 5.74]; p = 0.01) and P-wave dispersion (MD = 12.67 ms; 95% CI [10.73, 14.62]; p < 0.00001). AF recurrence on patients underwent pulmonary vein isolation (PVI) was highly associated with larger P-wave duration (MD = 13.92 ms; 95% CI [11.54, 16.30]; p < 0.00001) and P-wave dispersion (MD = 11.53 ms; 95% CI [8.41, 14.65]; p < 0.00001). However, the relation between P-wave duration and AF recurrence on cathether ablation yet to be determined (MD = 6.34 ms; 95% CI [-0.77, 13.44]; p < 0.00001). Conclusion P-wave and P-wave dispersion were considered as predictive factor for AF recurrence in patients underwent cardioversion and PVI.