Key result
Filtered P wave duration was significantly prolonged in patients with persistent atrial flutter 1 day after radiofrequency catheter ablation compared to controls (165 vs 134 ms) but significantly improved to 150 ms at 1 month.
Why the study?
Does radiofrequency catheter ablation improve atrial conduction abnormalities detected by P wave signal-averaged ECG in patients with persistent atrial flutter?
Observational (n=36)
No
Does radiofrequency catheter ablation improve atrial conduction abnormalities detected by P wave signal-averaged ECG in patients with persistent atrial flutter?
Absolute Event Rate: 165% vs 134%
p-value: p=<0.001
Atrial conduction abnormalities are present in patients with persistent atrial flutter and partially improve 1 month after radiofrequency catheter ablation.
May indicate reversible atrial conduction issues post-ablation; leaves open need for randomized outcome trials.
It has been reported that abnormalities of atrial conduction are present in patients with atrial flutter (AFL). We analyzed the P wave signal-averaged ECG (PSE) in patients after cardioversion of chronic AFL by radiofrequency catheter ablation (RFCA) to determine whether abnormalities of atrial conduction exist in patients with AFL and whether they recover. We studied 11 patients undergoing ablation of persistent AFL (AFL group), 11 patients with paroxysmal AFL (PAFL group), and 14 patients without any evidence of arrhythmias (control group). The PSEs were recorded 1 day, 7 days, and 1 month after RFCA. The filtered P wave duration (FPD) was calculated from the PSE recording. The FPD correlated with interatrial conduction time (r = 0.644) and left atrial dimension (r = 0.675) in combined assessment of the AFL and PAFL groups. The FPD was longer in the AFL group 1 day (165 +/- 14 ms, P < 0.001) and 1 month (150 +/- 18 ms, P < 0.05) after RFCA than in the control group (134 +/- 10 ms). Our findings suggest that atrial conduction abnormalities detected by PSE are present in patients with persistent AFL and improve 1 month after cardioversion.
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Miura et al. (2004) conducted an observational in Persistent Atrial Flutter (n=36). Radiofrequency catheter ablation vs. Healthy controls was evaluated on Filtered P wave duration (FPD) 1 day after ablation (p=<0.001). Filtered P wave duration was significantly prolonged in patients with persistent atrial flutter 1 day after radiofrequency catheter ablation compared to controls (165 vs 134 ms) but significantly improved to 150 ms at 1 month.
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