A P-Wave Area Index below 0.4781 msec*mV*m²/cm² identified low voltage areas with 81% accuracy (OR 20.578, AUC 0.860) in patients undergoing first atrial fibrillation ablation.
Observational (n=264)
Does the novel P-Wave Area Index (PWAi) predict the presence of low voltage areas in patients undergoing first AF ablation?
The novel P-Wave Area Index (PWAi) is a strong non-invasive predictor of low voltage areas prior to AF ablation, which may help individualize ablation strategies.
Odds Ratio: 20.578
Abstract Introduction Presence of low voltage areas (LVA) mirrors progression of atrial fibrillation (AF) and is associated with an impaired rhythm outcome after AF ablation. P-wave indices can predict LVA, however accuracy is depending on myocardial mass, therefore the P Wave area was indexed for the left atrial area. The aim of current analysis was to investigate the association between the novel P-Wave Area Index (PWAi) and the presence of LVA. Methods Patients undergoing first AF ablation were included into analysis. LVA were determined using high-density maps and defined as 0.5 mV. All patients underwent CMR imaging (Ingenia 1.5T Philips) and received 12 lead ecg in sinusrhythm before intervention. CMR data (LA area) and P-Wave Area in Leads I ( PWA(I)) and II (PWA(II)) were measured in all patients. Afterwards the P-Wave Area was indexed for LA area to create the PWAi. Results A total of 264 consecutive patients were included in the analysis (65 years, 41% females, 57% persistent AF, 30.6% LVAs). Of all analyzed P-Wave indices, P Wave Area in lead II could effectively identify LVA (AUC: 0.813, p0.001). In patients with LVA, PWAi below 0.4781 msec*mV*m²/cm² identified patients with LVA with an accuracy of 81% (81% sensitivity, 81% specificity, 65% pos. predictive value and 91% neg. predictive value) and was the strongest predictor among all analyzed parameters (OR: 20,578, AUC; 0.860) Conclusion The PWAi is a highly significant tool to identify potential LVA before AF Ablation. This findings help to further individualize AF treatment.Multivariate AnalysisROC analysis
Seewoester et al. (Wed,) conducted a observational in atrial fibrillation (n=264). P-Wave Area Index (PWAi) was evaluated on Presence of low voltage areas (LVA) <0.5 mV (OR 20.578). A P-Wave Area Index below 0.4781 msec*mV*m²/cm² identified low voltage areas with 81% accuracy (OR 20.578, AUC 0.860) in patients undergoing first atrial fibrillation ablation.
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