Key result
Pulmonary vein isolation significantly decreased P-wave duration (144.1 vs 135.1 ms, p=0.02), integral of P-wave potentials, and total P-wave, reflecting changes in left atrial properties.
Why the study?
Comprehensive surveillance for interval changes in signal-averaged P-wave after pulmonary vein isolation was lacking.
Does pulmonary vein isolation alter signal-averaged P-wave parameters in patients with paroxysmal atrial fibrillation?
Observational (n=18)
Does pulmonary vein isolation alter signal-averaged P-wave parameters in patients with paroxysmal atrial fibrillation?
p-value: p=0.02
Signal-averaged P-wave parameters and left atrial electrical properties consistently decrease after pulmonary vein isolation, suggesting SAPW could be a noninvasive tool to monitor PVI response.
BACKGROUND: The comprehensive surveillance for interval changes in signal-averaged P-wave (SAPW) after pulmonary vein isolation (PVI) remains lacking. We aimed to analyze the SAPW parameters before and after PVI and explored their link to the left atrial electrical properties. METHODS: Eighteen patients with paroxysmal atrial fibrillation receiving primary catheter ablation were enrolled. SAPW parameters, including root mean square voltages in the last 40, 30, and 20 ms (RMS40, RMS30, and RMS20, respectively), the total P-wave (RMSt), the integral of P-wave potentials (Int-p), and P-wave duration (fPWD), were measured before and after PVI and correlated to the left atrial activation time (LAT) and mean left atrial voltage (LAV) from electro-anatomical mapping. RESULTS: Compared with the SAPW before PVI, fPWD (before vs after PVI: 144.1 ± 5.2 vs 135.1 ± 11.9 ms, p = 0.02), Int-p (687.4 ± 173.1 vs 559 ± 202.5 mVms, p = 0.01), and RMSt (6.44 ± 1.3 vs 5.44 ± 2.0 mV, p = 0.04) all decreased after PVI. RMS20, RMS30, and RMS40 showed no significant difference. Similarly, LAT (97.5 ± 9.3 vs 90.5 ± 9.3 ms, p = 0.008) and LAV (1.37 ± 0.27 vs 0.96 ± 0.31 mV, p = 0.001) decreased after PVI. Although consistent changes after PVI were observed between SAPW parameters and LAT or LAV, no linear correlation was observed among them. CONCLUSION: The consistent changes in SAPW and left atrial electrical properties after PVI suggest that SAPW may be used as a noninvasive tool to monitor the responses to PVI.
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Yugo et al. (2022) conducted an observational in Paroxysmal atrial fibrillation (n=18). Pulmonary vein isolation (PVI) vs. Before PVI was evaluated on P-wave duration (fPWD) (p=0.02). Pulmonary vein isolation significantly decreased P-wave duration (144.1 vs 135.1 ms, p=0.02), integral of P-wave potentials, and total P-wave, reflecting changes in left atrial properties.
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