Ratio of P-Wave Duration to P-Wave Amplitude and Left Atrial Remodeling : Insights from Electrophysiological Findings and Myocardial Injury After Cryoballoon Ablation
Copyright © 2023 Elsevier Inc. All rights reserved..
The impact of the P-wave morphology on clinical outcomes postcatheter ablation (post-CA) and recurrent arrhythmia characteristics or electrophysiologic findings in patients with paroxysmal atrial fibrillation (PAF) remains unclear. Patients with PAF who underwent cryoballoon ablation were enrolled. In 12-lead electrocardiography recorded within 1 month before CA, the P-wave duration (Pd) and P-wave vector magnitude (Pvm) (square root of the sum of the squared P-wave amplitude in leads II, V6, and one-half of the P-wave amplitude in V2) were measured and divided into 2 groups: patients with high and low Pd/Pvm based on a statistically calculated cut-off value. We evaluated the incidence of late recurrence of atrial fibrillation (LRAF), myocardial injury (high-sensitive troponin I), and the electrophysiologic findings in repeat ablation sessions. This study included 269 patients with PAF. The median follow-up duration was 697 days. The cut-off value of the Pd/Pvm for predicting LRAF was 740.7 ms/mV (area under the curve = 0.81, sensitivity = 58.2%, and specificity = 89.6%). Multivariable Cox proportional hazards analysis showed that high Pd/Pvm (>740.7 ms/mV) was significantly associated with LRAF (p <0.001). The high-sensitive troponin I level was significantly lower, and the ratio of DR-FLASH score >3 was significantly higher in those with high than low Pd/Pvm (p = 0.044 and p = 0.002, respectively). In the repeat ablation sessions, the Pd/Pvm in patients with atrial tachycardia-induced or spontaneously occurring during the repeat CA sessions was significantly higher than in those without (p = 0.009). There was a significant difference between the Pd/Pvm and low-voltage area (p <0.001). In conclusion, the Pd/Pvm is significantly associated with LRAF after cryoballoon ablation in patients with PAF and predicts left atrial low-voltage areas and atrial tachycardia inducibility.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2024 |
|---|---|
| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:212 |
|---|---|
| Enthalten in: |
The American journal of cardiology - 212(2024) vom: 01. Jan., Seite 109-117 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
Yano, Masamichi [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Cryoballoon ablation |
|---|
| Anmerkungen: |
Date Completed 22.01.2024 Date Revised 22.01.2024 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.1016/j.amjcard.2023.11.046 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM365271713 |
|---|
| LEADER | 01000caa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM365271713 | ||
| 003 | DE-627 | ||
| 005 | 20240122231947.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231226s2024 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.1016/j.amjcard.2023.11.046 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1267.xml |
| 035 | |a (DE-627)NLM365271713 | ||
| 035 | |a (NLM)38036050 | ||
| 035 | |a (PII)S0002-9149(23)01339-5 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a Yano, Masamichi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Ratio of P-Wave Duration to P-Wave Amplitude and Left Atrial Remodeling |b Insights from Electrophysiological Findings and Myocardial Injury After Cryoballoon Ablation |
| 264 | 1 | |c 2024 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 22.01.2024 | ||
| 500 | |a Date Revised 22.01.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Elsevier Inc. All rights reserved. | ||
| 520 | |a The impact of the P-wave morphology on clinical outcomes postcatheter ablation (post-CA) and recurrent arrhythmia characteristics or electrophysiologic findings in patients with paroxysmal atrial fibrillation (PAF) remains unclear. Patients with PAF who underwent cryoballoon ablation were enrolled. In 12-lead electrocardiography recorded within 1 month before CA, the P-wave duration (Pd) and P-wave vector magnitude (Pvm) (square root of the sum of the squared P-wave amplitude in leads II, V6, and one-half of the P-wave amplitude in V2) were measured and divided into 2 groups: patients with high and low Pd/Pvm based on a statistically calculated cut-off value. We evaluated the incidence of late recurrence of atrial fibrillation (LRAF), myocardial injury (high-sensitive troponin I), and the electrophysiologic findings in repeat ablation sessions. This study included 269 patients with PAF. The median follow-up duration was 697 days. The cut-off value of the Pd/Pvm for predicting LRAF was 740.7 ms/mV (area under the curve = 0.81, sensitivity = 58.2%, and specificity = 89.6%). Multivariable Cox proportional hazards analysis showed that high Pd/Pvm (>740.7 ms/mV) was significantly associated with LRAF (p <0.001). The high-sensitive troponin I level was significantly lower, and the ratio of DR-FLASH score >3 was significantly higher in those with high than low Pd/Pvm (p = 0.044 and p = 0.002, respectively). In the repeat ablation sessions, the Pd/Pvm in patients with atrial tachycardia-induced or spontaneously occurring during the repeat CA sessions was significantly higher than in those without (p = 0.009). There was a significant difference between the Pd/Pvm and low-voltage area (p <0.001). In conclusion, the Pd/Pvm is significantly associated with LRAF after cryoballoon ablation in patients with PAF and predicts left atrial low-voltage areas and atrial tachycardia inducibility | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a P-wave duration | |
| 650 | 4 | |a P-wave vector magnitude | |
| 650 | 4 | |a cryoballoon ablation | |
| 650 | 4 | |a low voltage area | |
| 650 | 4 | |a myocardial injury | |
| 650 | 4 | |a paroxysmal atrial fibrillation | |
| 650 | 4 | |a recurrence | |
| 650 | 7 | |a Troponin I |2 NLM | |
| 700 | 1 | |a Egami, Yasuyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Kawanami, Shodai |e verfasserin |4 aut | |
| 700 | 1 | |a Ukita, Kohei |e verfasserin |4 aut | |
| 700 | 1 | |a Kawamura, Akito |e verfasserin |4 aut | |
| 700 | 1 | |a Yasumoto, Koji |e verfasserin |4 aut | |
| 700 | 1 | |a Tsuda, Masaki |e verfasserin |4 aut | |
| 700 | 1 | |a Okamoto, Naotaka |e verfasserin |4 aut | |
| 700 | 1 | |a Matsunaga-Lee, Yasuharu |e verfasserin |4 aut | |
| 700 | 1 | |a Nishino, Masami |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t The American journal of cardiology |d 1958 |g 212(2024) vom: 01. Jan., Seite 109-117 |w (DE-627)NLM000025364 |x 1879-1913 |7 nnns |
| 773 | 1 | 8 | |g volume:212 |g year:2024 |g day:01 |g month:01 |g pages:109-117 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.1016/j.amjcard.2023.11.046 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 212 |j 2024 |b 01 |c 01 |h 109-117 | ||