Key result
Increased P-wave dispersion, prolonged P-LAA interval, and LA/LAA abnormalities linked to AF recurrence.
Why the study?
Patients with essential hypertension have a higher recurrence rate of atrial fibrillation, but predictors of recurrence after conversion are not well defined.
What are the electrocardiographic and echocardiographic predictors of atrial fibrillation recurrence in patients with essential hypertension?
Cohort (n=136)
What are the electrocardiographic and echocardiographic predictors of atrial fibrillation recurrence in patients with essential hypertension?
Increased P-wave dispersion, prolonged P-LAA interval, dilated left atrium, and depressed left atrial appendage function can help identify hypertensive patients at high risk for recurrent atrial fibrillation.
May aid atrial parameter-based risk stratification in hypertensive AF; hypothesis-generating and should not yet change practice.
BACKGROUND: Patients with essential hypertension had a higher recurrence rate of atrial fibrillation (AF) than patients without hypertension. This study evaluated the role of various parameters for predicting recurrence after conversion of AF in patients with essential hypertension. METHODS: We retrospectively analyzed 136 patients with essential hypertension and a known history of AF. P-wave duration and dispersion were measured in a 12-lead electrocardiograph. The size and function of the left atrium (LA) and left atrial appendage (LAA) were assessed by transthoracic and transesophageal echocardiography. The time interval from initiation of P-wave to the start of LAA ejection flow (P-LAA) was measured at the same time. All the patients were followed up for a period of 12 +/- 6 months for the recurrence of AF. RESULTS: In the follow-up period, 38.2%of patients underwent AF recurrence. Age, P-LAA, P(max), P-wave dispersion, left atrium diameter (LAD), and maximum and minimum LAA volume were significantly higher in patients with AF recurrence than in patients without AF recurrence, while EF-LAA and LAA peak emptying velocity were much lower in patients with AF recurrence. P-LAA had positive correlation with LAD and P-wave dispersion (r = 0.501, p < 0.0001; r = 0.713, p < 0.0001). CONCLUSION: These results indicated that increased P-wave dispersion, P-LAA in addition to the dilated LA, and the depressed LAA function may be useful to identify patients with hypertension at risk of recurrent AF.
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Ma et al. (2009) conducted a cohort in Essential hypertension and a known history of atrial fibrillation (n=136). Echocardiographic and electrocardiographic parameters (P-wave dispersion, P-LAA, LA/LAA size and function) was evaluated on Recurrence of atrial fibrillation. Increased P-wave dispersion, prolonged P-LAA interval, dilated left atrium, and depressed left atrial appendage function were significantly associated with atrial fibrillation recurrence (38.2% overall).
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