Key result
Positive atrial late potentials on pre-ablation P-SAECG predict ~283% higher 1-year AF recurrence.
Why the study?
To assess the association between atrial fibrillation recurrence after catheter ablation and atrial late potentials measured using P-wave signal-averaged electrocardiography.
Do positive atrial late potentials on pre-ablation P-SAECG predict atrial fibrillation recurrence in patients with paroxysmal AF undergoing their first catheter ablation?
Observational (n=190)
No
Do positive atrial late potentials on pre-ablation P-SAECG predict atrial fibrillation recurrence in patients with paroxysmal AF undergoing their first catheter ablation?
Positive atrial late potentials measured by pre-ablation P-wave signal-averaged ECG independently predict atrial fibrillation recurrence at 1 year after first catheter ablation.
Answers are grounded in this paper and cite their sources.
May support pre-ablation risk stratification in paroxysmal AF; leaves open prospective validation before guiding patient selection.
Background Previous studies have identified noninvasive methods for predicting atrial fibrillation (AF) recurrence after catheter ablation (CA). We assessed the association between AF recurrence and atrial late potentials (ALPs), which were measured using P‐wave signal‐averaged electrocardiography (P‐SAECG). Methods Consecutive patients with paroxysmal AF who underwent their first CA at our institution between August 2015 and August 2019 were enrolled. P‐SAECG was performed before CA. Two ALP parameters were evaluated: the root‐mean‐square voltage during the terminal 20 ms (RMS 20 ) and the P‐wave duration (PWD). Positive ALPs were defined as an RMS 20 <2.2 μV and/or a PWD >115 ms. Patients were allocated to either the recurrence or nonrecurrence group based on the presence of AF recurrence at the 1‐year follow‐up post‐CA. Results Of the 190 patients (age: 65 ± 11 years, 37% women) enrolled in this study, 21 (11%) had AF recurrence. The positive ALP rate was significantly higher in the recurrence group than in the nonrecurrence group (86% vs. 64%, p = .04), despite the absence of 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 = .04). Conclusions Positive ALP on pre‐CA P‐SAECG is associated with AF recurrence after CA.
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Saito et al. (2022) conducted an observational in Paroxysmal atrial fibrillation (n=190). Positive atrial late potentials (ALPs) vs. Negative atrial late potentials was evaluated on Atrial fibrillation recurrence (OR 3.83, 95% CI 1.05-14.1, p=0.04). Positive atrial late potentials on pre-catheter ablation P-wave signal-averaged electrocardiography independently predicted atrial fibrillation recurrence at 1 year (OR 3.83).
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