A maximum P-wave duration of ≥142 ms on a 12-lead ECG independently predicted the recurrence of atrial fibrillation within 1 month after electrical cardioversion (OR 0.33).
Observational (n=77)
Single-blind
No
Do abnormalities of P-wave morphology on the surface ECG predict recurrent AF following electrical cardioversion in patients with persistent AF?
Prolonged maximum P-wave duration (≥142 ms) on a post-cardioversion 12-lead ECG independently predicts atrial fibrillation recurrence at 1 month.
Estimación del efecto: OR 0.33 (95% CI 0.13-0.87)
valor p: p=0.025
BACKGROUND: Maintenance of atrial fibrillation (AF) is related to atrial electrical inhomogeneity and resultant chaotic reentry. Our aim was to test the hypothesis that abnormalities of P morphology on the surface electrocardiogram (ECG) predict recurrent AF following electrical cardioversion (ECV). METHODS: A 12-lead ECG was recorded after ECV for persistent AF in 77 patients (51 men, 65 ± 10 years) and repeated 1 month later. P-wave duration was obtained in each lead using blinded on-screen measurement. Maximum P-wave duration (P-max) was defined as the longest measurable P-wave duration in any lead. P-wave dispersion (PWd) was calculated as the maximum-minimum P-wave duration. RESULTS: One month after ECV, 29 (38%) patients maintained sinus rhythm. Compared with the sinus rhythm group, those with recurrent AF had significantly greater PWd (66 ± 19 vs 57 ± 16 ms, P = 0.024) and included more patients with P-max ≥142 ms (65% vs 38%, P = 0.023). Using a cutoff of ≥62 ms for PWd and ≥142 ms for P-max, both indices had similar predictive value (sensitivity 66.7 and 64.6%, specificity 58.6 and 62.1%, respectively). In multiple regression analysis, including established clinical predictors, P-max ≥142 ms was the only independent predictor of AF recurrence (P = 0.025). CONCLUSION: A prolonged P-wave duration measured by 12-lead ECG predicts recurrent AF within 1 month after ECV.
Gonna et al. (Tue,) conducted a observational in Persistent atrial fibrillation (n=77). Maximum P-wave duration ≥142 ms vs. Maximum P-wave duration <142 ms was evaluated on Recurrence of atrial fibrillation within 1 month (OR 0.33, 95% CI 0.13-0.87, p=0.025). A maximum P-wave duration of ≥142 ms on a 12-lead ECG independently predicted the recurrence of atrial fibrillation within 1 month after electrical cardioversion (OR 0.33).