The P-wave Time-domain Significant Features to Evaluate Substrate Modification After Catheter Ablation of Paroxysmal Atrial Fibrillation

The outcome of catheter ablation (CA) of atrial fibrillation (AF) is vastly analyzed by the entire P-wave duration (PWD).However, the first and second P-wave parts, corresponding to right (RA) and left atrial (LA) wavefront propagation, may be unequally modified.Five-minute lead II recordings before and after the first-ever CA of 40 paroxysmal AF patients were analyzed and P-wave features were calculated: PWD on-off of the entire P-wave and each P-wave part (RA: PWD on-peak , LA: PWD peak-off ) and the time from P-wave onset or offset to the R-peak (PWD on-R and PWD off-R , respectively).Heart-rate (HR) adjustment (HRA) mitigated the HR fluctuations.Pre/post-CA comparison was performed with Mann-Whitney U-test and median values were calculated.Pearson's correlation was calculated between PWD and the remaining features.The effect of CA with ( : -17.96%) or without HRA ( : -9.84%) was significant at the entire PWD on-off and at the PWD peak-off (HRA: : -27.77%, no HRA: : -22.03%).PWD on-off showed a stronger correlation with RA than LA ( max = 0.805 vs max = 0.541).P-wave features corresponding to RA are more strongly related to the entire P-wave.Nevertheless, only the Pwave part associated with LA is significantly affected by CA.That being so, studies are encouraged to incorporate part-time P-wave analysis.