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Post-ablation P wave characteristics correlate with recurrent atrial fibrillation in the ABCD-AF cohort

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Purpose

Atrial fibrillation (AF) ablation is a common procedure to reduce cardiovascular morbidity but is limited by recurrence. The objective of this study was to determine if post-ablation acute surface P wave morphology and other electrocardiographic parameters correlate with AF recurrence.

Methods

The Avoiding Bladder Catheters During AF ablation (ABCD-AF) trial was a randomized, prospective trial in 160 subjects undergoing AF ablation. The present study examined correlation between AF recurrence in follow-up and acute post-ablation electrocardiographic P wave parameters.

Results

Median follow-up was 255 (188, 306) days. The ABCD-AF cohort had a mean age of 62.7 ± 12.8 with 32.1% being females. Rate of recurrent AF was 35.8%, with a median time to AF of 135 (109, 182) days. There was no baseline demographic associated with AF recurrence. There was more AF recurrence in those with longer follow-up (p = 0.001). Lead 2 PR interval, lead 2 P wave duration/PR (Pdur/PR), lead V1 PR interval, and lead V1 Pdur/PR were all significantly associated with recurrent AF (p = 0.03, 0.02, 0.01, 0.01). Longer PR and shorter Pdur/PR predicted AF recurrence. In a multivariable model, lead V1 Pdur/PR provided the best predictor of AF recurrence, with an odds ratio of 0.018 (p = 0.016) per standard deviation change.

Conclusions

Shorter P wave duration combined with longer AV node delay, as measured by proportion of the PR that the P wave occupies, was the best predictor of AF recurrence post-ablation.

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Data availability

Relevant data is disclosed within the body of the manuscript and full data will be made available upon reasonable request.

Code availability

There is no code availability to disclose.

Abbreviations

ABCD-AF:

Avoiding Bladder Catheters During AF ablation

AF:

Atrial fibrillation

CA:

Catheter ablation

ECG:

Electrocardiogram

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Authors and Affiliations

  1. St Vincent Medical Group, 8333 Naab Road, #400, Indianapolis, IN, 46260, USA

    Neil Supanekar, Jasen L. Gilge, Asim Ahmed & Parin J. Patel

Authors
  1. Neil Supanekar
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  2. Jasen L. Gilge
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  3. Asim Ahmed
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Contributions

All authors of this manuscript have contributed a sufficient amount to be included as an author. All authors have reviewed the data and manuscript and approve this document.

Corresponding author

Correspondence to Jasen L. Gilge.

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Ethics approval

This research project did receive IRB and ethics approval from our local institution.

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Consent was not required given the retrospective nature of the project.

Consent for publication

Consent was not required given the retrospective nature of the project.

Conflict of interest

PJP has received honoraria from Biosense Webster, Inc. None of the other authors have any conflicts of interest to disclose.

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Supanekar, N., Gilge, J.L., Ahmed, A. et al. Post-ablation P wave characteristics correlate with recurrent atrial fibrillation in the ABCD-AF cohort. J Interv Card Electrophysiol 64, 437–442 (2022). https://doi.org/10.1007/s10840-021-01049-0

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  • DOI: https://doi.org/10.1007/s10840-021-01049-0

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