Maximum P-wave duration and P-wave dispersion predict recurrence of paroxysmal atrial fibrillation in patients with Wolff-Parkinson-White syndrome after successful radiofrequency catheter ablation
Journal of Interventional Cardiac Electrophysiology, cilt.11, sa.1, ss.21-27, 2004 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 11 Sayı: 1
- Basım Tarihi: 2004
- Doi Numarası: 10.1023/b:jice.0000035925.90831.80
- Dergi Adı: Journal of Interventional Cardiac Electrophysiology
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Sayfa Sayıları: ss.21-27
- Anahtar Kelimeler: P-wave dispersion, paroxysmal atrial fibrillation, Wolff-Parkinson-White syndrome
- Sağlık Bilimleri Üniversitesi Adresli: Hayır
Özet
Background: Identification of patients at risk for PAF recurrence after AP ablation is important because of the necessity for additional therapies. Objectives: To determine whether Maximum P-wave duration (P max) and P-wave dispersion (P d) detected on surface ECG after successful accessory pathway (AP) ablation can predict the recurrence of paroxysmal atrial fibrillation (PAF). Methods: Seventy-eight patients with Wolff-Parkinson-White (WPW) syndrome who had at least one documented PAF episode and underwent catheter ablation were enrolled. P max, minimum P-wave duration (P min) and P d were determined on a surface ECG recorded on a high resolution computer screen on day 2 after ablation of the AP. Results: There was no significant difference in terms of basic clinical data and electrophysiological findings between patients with (Group-1, n = 19) and without (Group-2, n = 59) recurrence of PAF during follow-up of 21 ± 10 months. P max and P d were significantly higher in Group-1 than Group-2 (120 ± 15 vs. 96 ± 10 ms and 47 ± 12 vs. 25 ± 7 ms, respectively; p < 0.001 for both). P min didn't differ significantly. A P max value of ≥ 103 ms separated Group-1 from Group-2 with a sensitivity of 84.2%, specificity of 72.9%, positive predictive value of 50%, and negative predictive value of 93.5%. A P d value of ≥ 32.5 ms separated Group-1 from Group-2 with a sensitivity of 89.5%, specificity of 84.7%, positive predictive value of 65.4%, and negative predictive value of 96.2%. P max (p < 0.010) and P d (p < 0.001) were found to be significant univariate predictors of PAF, whereas only P d remained significant in multivariate analysis (p = 0.037). Conclusion: P d ≥ 32.5 ms and P max ≥ 103.0 ms predict the recurrence of PAF after ablation with acceptable positive and negative predictive values. P d ≥ 32.5 ms is an independent predictor of recurrence of PAF after catheter ablation in patients with WPW syndrome.