Key result
Positive atrial late potentials on pre-ablation ECG predict ~283% higher 1-year AF recurrence.
Why the study?
Few non-invasive parameters have been identified for predicting AF recurrence after catheter ablation.
Do positive atrial late potentials on pre-ablation P-SAECG predict atrial fibrillation recurrence in patients with paroxysmal AF undergoing first catheter ablation?
Cohort (n=190)
No
Do positive atrial late potentials on pre-ablation P-SAECG predict atrial fibrillation recurrence in patients with paroxysmal AF undergoing first catheter ablation?
Positive atrial late potentials on pre-ablation P-SAECG independently predict atrial fibrillation recurrence at 1 year in patients undergoing their first catheter ablation for paroxysmal AF.
Answers are grounded in this paper and cite their sources.
May support P-SAECG for post-ablation recurrence risk stratification; hypothesis-generating and should not yet change practice.
Introduction: Few non-invasive parameters have been identified for predicting atrial fibrillation (AF) recurrence after catheter ablation (CA). This study aimed to assess the association between AF recurrence and atrial late potentials (ALP) measured using P-wave signal-averaged electrocardiography (P-SAECG). Methods and results: Consecutive patients with paroxysmal AF who underwent first CA at our institution between August 2015 and August 2019 were enrolled. P-SAECG was performed before CA. Two ALP parameters were evaluated: root mean square voltage during the terminal 20 ms (RMS 20 ) and P-wave duration (PWD). Positive ALP was defined as an RMS 20 <2.2 µV and/or a PWD >115 ms. Patients were divided into the Recurrence and Non-recurrence groups based on AF recurrence at the 1-year follow-up after CA. Of 190 patients (age: 65±11 years, 37% women) enrolled in this study, 21 (11%) had AF recurrence. Positive ALP rate was significantly higher in the Recurrence group than in the Non-Recurrence group (86% vs. 64%, P =0.04) despite there being no differences in other baseline characteristics between the two groups. In the multivariate analysis, positive ALP was an independent predictor of AF recurrence (odds ratio: 3.83, 95% confidence interval: 1.05–14.1, P =0.04). Conclusion: Positive ALP on pre-CA P-SAECG was associated with AF recurrence after CA.
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Saito et al. (2024) conducted a cohort in Paroxysmal atrial fibrillation (n=190). Positive atrial late potentials (ALP) vs. Negative ALP was evaluated on Atrial fibrillation recurrence at 1-year follow-up (OR 3.83, 95% CI 1.05-14.1, p=0.04). Positive atrial late potentials on pre-ablation ECG independently predicted atrial fibrillation recurrence at 1 year after catheter ablation (OR 3.83; 95% CI 1.05-14.1; P=0.04).
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