Amplified sinus-P-wave analysis predicts outcomes of cryoballoon ablation in patients with persistent and long-standing persistent atrial fibrillation : A multicentre study
Creta, Antonio (University College London)
Venier, Sandrine (Grenoble University Hospital and Grenoble Alpes University)
Tampakis, Konstantinos (Clinique Pasteur)
Providencia, Rui (University College London)
Sunny, Juno (St Bartholomew's Hospital)
Defaye, Pascal (Grenoble University Hospital and Grenoble Alpes University)
Earley, Mark J. (St Bartholomew's Hospital)
Finlay, Malcolm (St Bartholomew's Hospital)
Hunter, Ross J. (St Bartholomew's Hospital)
Lambiase, Pier D. (St Bartholomew's Hospital)
Papageorgiou, Nikolaos (St Bartholomew's Hospital)
Schilling, Richard J. (St Bartholomew's Hospital)
Sporton, Simon (St Bartholomew's Hospital)
Andrikopoulos, George (Henry Dunant Hospital Center)
Deschamps, Elodie (Grenoble University Hospital and Grenoble Alpes University)
Albenque, Jean-Paul (Clinique Pasteur)
Cardin, Christèle (Clinique Pasteur)
Combes, Nicolas (Clinique Pasteur)
Combes, Stéphane (Clinique Pasteur)
Vinolas, Xavier (Institut d'Investigació Biomèdica Sant Pau)
Moreno Weidmann, Zoraida (Institut d'Investigació Biomèdica Sant Pau)
Huang, Taiyuan (University of Freiburg)
Eichenlaub, Martin (University of Freiburg)
Müller-Edenborn, Björn (University of Freiburg)
Arentz, Thomas (University of Freiburg)
Jadidi, Amir (University of Freiburg)
Boveda, Serge (Clinique Pasteur)
Universitat Autònoma de Barcelona

Date:	2023
Abstract:	Outcomes of catheter ablation for non-paroxysmal atrial fibrillation (AF) remain suboptimal. Non-invasive stratification of patients based on the presence of atrial cardiomyopathy (ACM) could allow to identify the best responders to pulmonary vein isolation (PVI). Observational multicentre retrospective study in patients undergoing cryoballoon-PVI for non-paroxysmal AF. The duration of amplified P-wave (APW) was measured from a digitally recorded 12-lead electrocardiogram during the procedure. If patients were in AF, direct-current cardioversion was performed to allow APW measurement in sinus rhythm. An APW cut-off of 150 ms was used to identify patients with significant ACM. We assessed freedom from arrhythmia recurrence at long-term follow-up in patients with APW ≥ 150 ms vs. APW < 150 ms. We included 295 patients (mean age 62. 3 ± 10. 6), of whom 193 (65. 4%) suffered from persistent AF and the remaining 102 (34. 6%) from long-standing persistent AF. One-hundred-forty-two patients (50. 2%) experienced arrhythmia recurrence during a mean follow-up of 793 ± 604 days. Patients with APW ≥ 150 ms had a significantly higher recurrence rate post ablation compared to those with APW < 150 ms (57. 0% vs. 41. 6%; log-rank p < 0. 001). On a multivariable Cox-regression analysis, APW≥150 ms was the only independent predictor of arrhythmia recurrence post ablation (HR 2. 03 CI 1. 28-3. 21; p = 0. 002). APW duration predicts arrhythmia recurrence post cryoballoon-PVI in persistent and long-standing persistent AF. An APW cut-off of 150 ms allows to identify patients with significant ACM who have worse outcomes post PVI. Analysis of APW represents an easy, non-invasive and highly reproducible diagnostic tool which allows to identify patients who are the most likely to benefit from PVI-only approach.
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	P-wave duration ; Arrhythmogenic substrate ; Atrial cardiomyopathy ; Atrial fibrillation ablation outcomes ; Cryoballoon ; Fibrosis ; Interatrial block ; Low voltage
Published in:	Frontiers in Cardiovascular Medicine, Vol. 10 (2023) , p. 1110165, ISSN 2297-055X

DOI: 10.3389/fcvm.2023.1110165
PMID: 37051067

8 p, 2.1 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
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