Key result
Abnormal PTFV1 at 3 months post-ablation predicts ~105% higher AF recurrence risk.
Why the study?
P-wave terminal force in lead V1 is a marker of atrial remodeling, but its role three months after AF or CTI ablation required evaluation.
Does abnormal P-wave terminal force in lead V1 at 3 months post-ablation predict atrial fibrillation recurrence in patients undergoing AF or CTI ablation?
Does abnormal P-wave terminal force in lead V1 at 3 months post-ablation predict atrial fibrillation recurrence in patients undergoing AF or CTI ablation?
An abnormal P-wave terminal force in lead V1 at 3 months post-ablation is a robust predictor of arrhythmia recurrence in patients undergoing AF ablation, but has limited predictive value following CTI ablation.
May guide monitoring intensity after AF ablation; extends ECG-based recurrence prediction but leaves utility after CTI ablation open.
Introduction: P-wave terminal force in lead V1 (PTFV1, Morris Index) is a marker of atrial remodeling. We evaluated its role three months after atrial fibrillation (AF) or cavotricuspid isthmus (CTI) ablation. Methods: A total of 120 AF patients (46% persistent, 54% paroxysmal) and 58 CTI patients were analyzed. PTFV1 was measured pre-ablation and at three months. Abnormal PTFV1 was defined as ≥|0.04| mV·s. Patients were followed for 12 months. Endpoints were AF/AT recurrence in the AF cohort and new AF in the CTI cohort. Results: In the AF cohort, recurrence occurred in 31%. Abnormal 3-month PTFV1 predicted higher recurrence (46% vs. 21%; HR 2.05, 95% CI 1.22–3.46). Addition of PTFV1 improved AUC from 0.67 to 0.76. In the CTI cohort, new AF occurred in 15%, but abnormal PTFV1 was not predictive (OR 1.8, 95% CI 0.8–4.2). Lead II P-wave duration was significant. Conclusion: Three-month PTFV1 is a robust predictor of AF recurrence after ablation. Its role in CTI ablation is limited.
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Arslan et al. (2026) studied this question. Abnormal PTFV1 at 3 months post-AF ablation predicted higher AF recurrence risk (46% vs 21%; HR 2.05) and improved prediction AUC from 0.67 to 0.76.
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