Key result
Higher beat-to-beat P-wave index linked to ~2.4-fold higher risk of post-ablation AF recurrence.
Why the study?
Identifying patients prone to AF relapse after catheter ablation is essential for risk stratification, prompting validation of a novel beat-to-beat P-wave morphological and wavelet analysis index to predict recurrence.
Does a higher beat-to-beat P-wave index predict atrial fibrillation recurrence in patients undergoing catheter ablation?
Cohort (n=138)
unblinded
Yes
Does a higher beat-to-beat P-wave index predict atrial fibrillation recurrence in patients undergoing catheter ablation?
Hazard Ratio: 2.35 (95% CI 1.24–4.44)
p-value: p=0.010
A novel beat-to-beat P-wave index based on morphological and wavelet analysis provides an independent pre-procedural predictor of atrial fibrillation recurrence after catheter ablation.
May refine pre-ablation AF recurrence prediction; leaves open whether it alters management pending prospective validation.
The identification of patients prone to atrial fibrillation (AF) relapse after catheter ablation is essential for better patient selection and risk stratification. The current prospective cohort study aims to validate a novel P-wave index based on beat-to-beat (B2B) P-wave morphological and wavelet analysis designed to detect patients with low burden AF as a predictor of AF recurrence within a year after successful catheter ablation. From a total of 138 consecutive patients scheduled for AF ablation, 12-lead ECG and 10 min vectorcardiogram (VCG) recordings were obtained. Univariate analysis revealed that patients with higher B2B P-wave index had a two-fold risk for AF recurrence (HR: 2.35, 95% CI: 1.24–4.44, p: 0.010), along with prolonged P-wave, interatrial block, early AF recurrence, female gender, heart failure history, previous stroke, and CHA2DS2-VASc score. Multivariate analysis of assessable predictors before ablation revealed that B2B P-wave index, along with heart failure history and a history of previous stroke or transient ischemic attack, are independent predicting factors of atrial fibrillation recurrence. Further studies are needed to assess the predictive value of the B2B index with greater accuracy and evaluate a possible relationship with atrial substrate analysis.
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Tachmatzidis et al. (2022) conducted a cohort in Atrial fibrillation (scheduled for catheter ablation) (n=138). Higher beat-to-beat (B2B) P-wave index vs. Lower beat-to-beat (B2B) P-wave index was evaluated on Atrial fibrillation recurrence within a year after successful catheter ablation (HR 2.35, 95% CI 1.24-4.44, p=0.010). A higher beat-to-beat P-wave index independently predicted a more than two-fold increased risk of atrial fibrillation recurrence after catheter ablation (HR 2.35).
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