Maximum P-wave duration in limb leads independently predicted early atrial fibrillation recurrence within 2 months after successful electrical cardioversion (OR 1.086; 95% CI 1.019-1.157; p=0.012).
Observational (n=272)
Do specific electrocardiographic parameters predict early recurrence of atrial fibrillation after successful electrical cardioversion in patients with persistent AF?
Maximum P-wave duration >134 ms and P-terminal force >50 ms × mm on post-cardioversion ECG are useful predictors of early AF recurrence, suggesting these patients may benefit from alternative rhythm or rate control strategies.
Effect estimate: OR 1.086 (95% CI 1.019-1.157)
p-value: p=0.012
Abstract Background Electrical cardioversion (ECV) is an effective method for restoring sinus rhythm after atrial fibrillation (AF). However, early recurrence of AF occurs in a significant number of patients after ECV. This study aimed to identify electrocardiographic (ECG) predictors of early AF recurrence after ECV. Methods A total of 272 patients with persistent AF undergoing successful ECV were consecutively enrolled in this study. We investigated clinical, echocardiographic, and ECG data. The 12‐lead ECG parameters were measured during sinus rhythm right after ECV using a digital caliper. The early AF recurrence was defined as recurrence within 2 months. Results Of the 272 patients, 165 patients (60.7%) experienced an early AF recurrence. Maximum P‐wave duration (PWD) in limb leads (OR: 1.086; 95% CI: 1.019–1.157; p = .012) and P‐terminal force (PTF) in V 1 (OR: 1.019; 95% CI: 1.004–1.033; p = .011) were independent predictors of early AF recurrence after ECV. The optimal cutoff value of the maximum PWD in limb leads for predicting early AF recurrence was 134 ms, characterized by 90.3% sensitivity and 72.0% specificity. Likewise, the optimal cutoff value of PTF in V 1 was 50 ms × mm, characterized by 80.0% sensitivity and 64.5% specificity. Conclusion A longer PWD (>134 ms) and a larger PTF (>50 ms × mm) were useful predictors of early recurrence of AF after successful ECV in clinical practice. A more effective rhythm control therapy such as catheter ablation or rate control strategy rather than a repeat ECV should be considered.
Choi et al. (Sat,) conducted a observational in Persistent atrial fibrillation (n=272). Electrocardiographic parameters (Maximum P-wave duration and P-terminal force) was evaluated on Early atrial fibrillation recurrence within 2 months (OR 1.086, 95% CI 1.019-1.157, p=0.012). Maximum P-wave duration in limb leads independently predicted early atrial fibrillation recurrence within 2 months after successful electrical cardioversion (OR 1.086; 95% CI 1.019-1.157; p=0.012).
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