Diagnostic value of electrocardiographic P-wave characteristics in atrial fibrillation recurrence and tachycardia-induced cardiomyopathy after catheter ablation
Abnormal P-wave characteristics were reportedly associated with left ventricular interstitial fibrosis as defined by cardiac magnetic resonance images. The objective of this study is to investigate the utility of P-wave characteristics to predict atrial fibrillation (AF) recurrence and the recovery...
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| Veröffentlicht in: | Heart and vessels 2018-11, Vol.33 (11), p.1381-1389 |
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| creator | Doi, Atsushi Takagi, Masahiko Katayama, Hisashi Yoshiyama, Tomotaka Hayashi, Yusuke Tatsumi, Hiroaki Yoshiyama, Minoru |
| description | Abnormal P-wave characteristics were reportedly associated with left ventricular interstitial fibrosis as defined by cardiac magnetic resonance images. The objective of this study is to investigate the utility of P-wave characteristics to predict atrial fibrillation (AF) recurrence and the recovery of left ventricular systolic dysfunction (LVSD) after catheter ablation (CA) for AF. Two hundred and five AF patients (109 paroxysmal and 96 persistent) who underwent CA were enrolled. We measured maximum P-wave duration (max PWD) and P-wave terminal force in lead V1 (PTFV1) calculated as a product of P-wave terminal amplitude (PTaV1) and duration (PTdV1) in lead V1 during sinus rhythm. AF recurrence was noted in 50 patients at 12 months after CA. Patients with AF recurrence had a higher prevalence of persistent AF, a larger left atrial volume, and a longer max PWD than those without. We divided the patients into 2 groups: 156 patients with left ventricular ejection fraction (LVEF) > 45% and 49 patients with LVEF ≤ 45% (Low-EF group). In Low-EF group, tachycardia-induced cardiomyopathy (TIC) was defined as improvement in LVEF ≥ 15% or LVEF ≥ 50% at 5 months after CA. TIC and non-TIC groups consisted of 37 and 12 patients, respectively. Max PWD, PTFV1, PTdV1, and PTaV1 were significantly greater in non-TIC-group than in TIC-group. PTFV1 had the highest diagnostic accuracy to discriminate between TIC and no-TIC-groups; cut-off value for PTFV1 was determined as 56.7 mV ms (area under the ROC curve = 0.80; 75% sensitivity; and 76% specificity). Max PWD was a useful predictor of AF recurrence and the complete recovery of LVSD after CA. PTFV1 had the highest diagnostic accuracy to discriminate between TIC and no-TIC-groups. |
| doi_str_mv | 10.1007/s00380-018-1179-4 |
| format | Article |
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The objective of this study is to investigate the utility of P-wave characteristics to predict atrial fibrillation (AF) recurrence and the recovery of left ventricular systolic dysfunction (LVSD) after catheter ablation (CA) for AF. Two hundred and five AF patients (109 paroxysmal and 96 persistent) who underwent CA were enrolled. We measured maximum P-wave duration (max PWD) and P-wave terminal force in lead V1 (PTFV1) calculated as a product of P-wave terminal amplitude (PTaV1) and duration (PTdV1) in lead V1 during sinus rhythm. AF recurrence was noted in 50 patients at 12 months after CA. Patients with AF recurrence had a higher prevalence of persistent AF, a larger left atrial volume, and a longer max PWD than those without. We divided the patients into 2 groups: 156 patients with left ventricular ejection fraction (LVEF) > 45% and 49 patients with LVEF ≤ 45% (Low-EF group). In Low-EF group, tachycardia-induced cardiomyopathy (TIC) was defined as improvement in LVEF ≥ 15% or LVEF ≥ 50% at 5 months after CA. TIC and non-TIC groups consisted of 37 and 12 patients, respectively. Max PWD, PTFV1, PTdV1, and PTaV1 were significantly greater in non-TIC-group than in TIC-group. PTFV1 had the highest diagnostic accuracy to discriminate between TIC and no-TIC-groups; cut-off value for PTFV1 was determined as 56.7 mV ms (area under the ROC curve = 0.80; 75% sensitivity; and 76% specificity). Max PWD was a useful predictor of AF recurrence and the complete recovery of LVSD after CA. PTFV1 had the highest diagnostic accuracy to discriminate between TIC and no-TIC-groups.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-018-1179-4</identifier><identifier>PMID: 29713820</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Ablation ; Adult ; Aged ; Aged, 80 and over ; Atrial Fibrillation - complications ; Atrial Fibrillation - diagnosis ; Atrial Fibrillation - surgery ; Biomedical Engineering and Bioengineering ; Cardiac arrhythmia ; Cardiac Surgery ; Cardiology ; Cardiomyopathies - diagnosis ; Cardiomyopathies - etiology ; Cardiomyopathies - physiopathology ; Cardiomyopathy ; Catheter Ablation - methods ; Catheters ; Diagnostic systems ; Echocardiography ; Electrocardiography ; Female ; Fibrillation ; Fibrosis ; Heart ; Heart Conduction System - physiopathology ; Heart Conduction System - surgery ; Heart diseases ; Heart Ventricles - diagnostic imaging ; Heart Ventricles - physiopathology ; Humans ; Magnetic resonance imaging ; Male ; Medical instruments ; Medicine ; Medicine & Public Health ; Middle Aged ; Original Article ; Patients ; Pulmonary Veins - surgery ; Radiofrequency ablation ; Recovery ; Recurrence ; Risk Factors ; ROC Curve ; Tachycardia ; Vascular Surgery ; Ventricle ; Ventricular Function, Left - physiology ; Young Adult</subject><ispartof>Heart and vessels, 2018-11, Vol.33 (11), p.1381-1389</ispartof><rights>Springer Japan KK, part of Springer Nature 2018</rights><rights>Heart and Vessels is a copyright of Springer, (2018). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-1c397ea3a0cc14b71ac5c098a899ec5c8d05d134d560600ce363c1f3535402033</citedby><cites>FETCH-LOGICAL-c462t-1c397ea3a0cc14b71ac5c098a899ec5c8d05d134d560600ce363c1f3535402033</cites><orcidid>0000-0002-2076-2796</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00380-018-1179-4$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00380-018-1179-4$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29713820$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Doi, Atsushi</creatorcontrib><creatorcontrib>Takagi, Masahiko</creatorcontrib><creatorcontrib>Katayama, Hisashi</creatorcontrib><creatorcontrib>Yoshiyama, Tomotaka</creatorcontrib><creatorcontrib>Hayashi, Yusuke</creatorcontrib><creatorcontrib>Tatsumi, Hiroaki</creatorcontrib><creatorcontrib>Yoshiyama, Minoru</creatorcontrib><title>Diagnostic value of electrocardiographic P-wave characteristics in atrial fibrillation recurrence and tachycardia-induced cardiomyopathy after catheter ablation</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description>Abnormal P-wave characteristics were reportedly associated with left ventricular interstitial fibrosis as defined by cardiac magnetic resonance images. The objective of this study is to investigate the utility of P-wave characteristics to predict atrial fibrillation (AF) recurrence and the recovery of left ventricular systolic dysfunction (LVSD) after catheter ablation (CA) for AF. Two hundred and five AF patients (109 paroxysmal and 96 persistent) who underwent CA were enrolled. We measured maximum P-wave duration (max PWD) and P-wave terminal force in lead V1 (PTFV1) calculated as a product of P-wave terminal amplitude (PTaV1) and duration (PTdV1) in lead V1 during sinus rhythm. AF recurrence was noted in 50 patients at 12 months after CA. Patients with AF recurrence had a higher prevalence of persistent AF, a larger left atrial volume, and a longer max PWD than those without. We divided the patients into 2 groups: 156 patients with left ventricular ejection fraction (LVEF) > 45% and 49 patients with LVEF ≤ 45% (Low-EF group). In Low-EF group, tachycardia-induced cardiomyopathy (TIC) was defined as improvement in LVEF ≥ 15% or LVEF ≥ 50% at 5 months after CA. TIC and non-TIC groups consisted of 37 and 12 patients, respectively. Max PWD, PTFV1, PTdV1, and PTaV1 were significantly greater in non-TIC-group than in TIC-group. PTFV1 had the highest diagnostic accuracy to discriminate between TIC and no-TIC-groups; cut-off value for PTFV1 was determined as 56.7 mV ms (area under the ROC curve = 0.80; 75% sensitivity; and 76% specificity). Max PWD was a useful predictor of AF recurrence and the complete recovery of LVSD after CA. PTFV1 had the highest diagnostic accuracy to discriminate between TIC and no-TIC-groups.</description><subject>Ablation</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Atrial Fibrillation - complications</subject><subject>Atrial Fibrillation - diagnosis</subject><subject>Atrial Fibrillation - surgery</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Cardiac arrhythmia</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Cardiomyopathies - diagnosis</subject><subject>Cardiomyopathies - etiology</subject><subject>Cardiomyopathies - physiopathology</subject><subject>Cardiomyopathy</subject><subject>Catheter Ablation - methods</subject><subject>Catheters</subject><subject>Diagnostic systems</subject><subject>Echocardiography</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Fibrillation</subject><subject>Fibrosis</subject><subject>Heart</subject><subject>Heart Conduction System - physiopathology</subject><subject>Heart Conduction System - surgery</subject><subject>Heart diseases</subject><subject>Heart Ventricles - diagnostic imaging</subject><subject>Heart Ventricles - physiopathology</subject><subject>Humans</subject><subject>Magnetic resonance imaging</subject><subject>Male</subject><subject>Medical instruments</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Original Article</subject><subject>Patients</subject><subject>Pulmonary Veins - surgery</subject><subject>Radiofrequency ablation</subject><subject>Recovery</subject><subject>Recurrence</subject><subject>Risk Factors</subject><subject>ROC Curve</subject><subject>Tachycardia</subject><subject>Vascular Surgery</subject><subject>Ventricle</subject><subject>Ventricular Function, Left - physiology</subject><subject>Young Adult</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kcuO1DAQRS0EYpqBD2CDLLFhY6iK8_ISDU9pJFjAOqp2Kh2P0nFjO4P6b_hUHDKAhMTKJdep48cV4inCSwRoXkUA3YICbBViY1R5T-ywxkoVVaPvix0YBNXqorkQj2K8AcDKoHkoLgrToG4L2IkfbxwdZh-Ts_KWpoWlHyRPbFPwlkLv_CHQaczdz-o73bK0IwWyiYNbZ6J0s6QUHE1ycPvgpomS87MMbJcQeLYsae5lIjuef_lIublfLPdy0x_P_kRpPEsasjRvppHXgvab6bF4MNAU-cndeim-vnv75eqDuv70_uPV62tly7pICq02DZMmsBbLfYNkKwumpdYYzmXbQ9WjLvuqhhrAsq61xUFXuiqhAK0vxYvNewr-28IxdUcXLef3zOyX2K3M-mWmyOjzf9Abv4Q5326lihqbWq8UbpQNPsbAQ3cK7kjh3CF0a3zdFl-X4-vW-Loyzzy7My_7I_d_Jn7nlYFiA2JuzQcOf4_-v_Un3AuodA</recordid><startdate>20181101</startdate><enddate>20181101</enddate><creator>Doi, Atsushi</creator><creator>Takagi, Masahiko</creator><creator>Katayama, Hisashi</creator><creator>Yoshiyama, Tomotaka</creator><creator>Hayashi, Yusuke</creator><creator>Tatsumi, Hiroaki</creator><creator>Yoshiyama, Minoru</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-2076-2796</orcidid></search><sort><creationdate>20181101</creationdate><title>Diagnostic value of electrocardiographic P-wave characteristics in atrial fibrillation recurrence and tachycardia-induced cardiomyopathy after catheter ablation</title><author>Doi, Atsushi ; Takagi, Masahiko ; Katayama, Hisashi ; Yoshiyama, Tomotaka ; Hayashi, Yusuke ; Tatsumi, Hiroaki ; Yoshiyama, Minoru</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-1c397ea3a0cc14b71ac5c098a899ec5c8d05d134d560600ce363c1f3535402033</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Ablation</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Atrial Fibrillation - complications</topic><topic>Atrial Fibrillation - diagnosis</topic><topic>Atrial Fibrillation - surgery</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>Cardiac arrhythmia</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Cardiomyopathies - diagnosis</topic><topic>Cardiomyopathies - etiology</topic><topic>Cardiomyopathies - physiopathology</topic><topic>Cardiomyopathy</topic><topic>Catheter Ablation - methods</topic><topic>Catheters</topic><topic>Diagnostic systems</topic><topic>Echocardiography</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Fibrillation</topic><topic>Fibrosis</topic><topic>Heart</topic><topic>Heart Conduction System - physiopathology</topic><topic>Heart Conduction System - surgery</topic><topic>Heart diseases</topic><topic>Heart Ventricles - diagnostic imaging</topic><topic>Heart Ventricles - physiopathology</topic><topic>Humans</topic><topic>Magnetic resonance imaging</topic><topic>Male</topic><topic>Medical instruments</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Original Article</topic><topic>Patients</topic><topic>Pulmonary Veins - surgery</topic><topic>Radiofrequency ablation</topic><topic>Recovery</topic><topic>Recurrence</topic><topic>Risk Factors</topic><topic>ROC Curve</topic><topic>Tachycardia</topic><topic>Vascular Surgery</topic><topic>Ventricle</topic><topic>Ventricular Function, Left - physiology</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Doi, Atsushi</creatorcontrib><creatorcontrib>Takagi, Masahiko</creatorcontrib><creatorcontrib>Katayama, Hisashi</creatorcontrib><creatorcontrib>Yoshiyama, Tomotaka</creatorcontrib><creatorcontrib>Hayashi, Yusuke</creatorcontrib><creatorcontrib>Tatsumi, Hiroaki</creatorcontrib><creatorcontrib>Yoshiyama, Minoru</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Doi, Atsushi</au><au>Takagi, Masahiko</au><au>Katayama, Hisashi</au><au>Yoshiyama, Tomotaka</au><au>Hayashi, Yusuke</au><au>Tatsumi, Hiroaki</au><au>Yoshiyama, Minoru</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnostic value of electrocardiographic P-wave characteristics in atrial fibrillation recurrence and tachycardia-induced cardiomyopathy after catheter ablation</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><addtitle>Heart Vessels</addtitle><date>2018-11-01</date><risdate>2018</risdate><volume>33</volume><issue>11</issue><spage>1381</spage><epage>1389</epage><pages>1381-1389</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><abstract>Abnormal P-wave characteristics were reportedly associated with left ventricular interstitial fibrosis as defined by cardiac magnetic resonance images. The objective of this study is to investigate the utility of P-wave characteristics to predict atrial fibrillation (AF) recurrence and the recovery of left ventricular systolic dysfunction (LVSD) after catheter ablation (CA) for AF. Two hundred and five AF patients (109 paroxysmal and 96 persistent) who underwent CA were enrolled. We measured maximum P-wave duration (max PWD) and P-wave terminal force in lead V1 (PTFV1) calculated as a product of P-wave terminal amplitude (PTaV1) and duration (PTdV1) in lead V1 during sinus rhythm. AF recurrence was noted in 50 patients at 12 months after CA. Patients with AF recurrence had a higher prevalence of persistent AF, a larger left atrial volume, and a longer max PWD than those without. We divided the patients into 2 groups: 156 patients with left ventricular ejection fraction (LVEF) > 45% and 49 patients with LVEF ≤ 45% (Low-EF group). In Low-EF group, tachycardia-induced cardiomyopathy (TIC) was defined as improvement in LVEF ≥ 15% or LVEF ≥ 50% at 5 months after CA. TIC and non-TIC groups consisted of 37 and 12 patients, respectively. Max PWD, PTFV1, PTdV1, and PTaV1 were significantly greater in non-TIC-group than in TIC-group. PTFV1 had the highest diagnostic accuracy to discriminate between TIC and no-TIC-groups; cut-off value for PTFV1 was determined as 56.7 mV ms (area under the ROC curve = 0.80; 75% sensitivity; and 76% specificity). Max PWD was a useful predictor of AF recurrence and the complete recovery of LVSD after CA. PTFV1 had the highest diagnostic accuracy to discriminate between TIC and no-TIC-groups.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>29713820</pmid><doi>10.1007/s00380-018-1179-4</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-2076-2796</orcidid></addata></record> |
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| subjects | Ablation Adult Aged Aged, 80 and over Atrial Fibrillation - complications Atrial Fibrillation - diagnosis Atrial Fibrillation - surgery Biomedical Engineering and Bioengineering Cardiac arrhythmia Cardiac Surgery Cardiology Cardiomyopathies - diagnosis Cardiomyopathies - etiology Cardiomyopathies - physiopathology Cardiomyopathy Catheter Ablation - methods Catheters Diagnostic systems Echocardiography Electrocardiography Female Fibrillation Fibrosis Heart Heart Conduction System - physiopathology Heart Conduction System - surgery Heart diseases Heart Ventricles - diagnostic imaging Heart Ventricles - physiopathology Humans Magnetic resonance imaging Male Medical instruments Medicine Medicine & Public Health Middle Aged Original Article Patients Pulmonary Veins - surgery Radiofrequency ablation Recovery Recurrence Risk Factors ROC Curve Tachycardia Vascular Surgery Ventricle Ventricular Function, Left - physiology Young Adult |
| title | Diagnostic value of electrocardiographic P-wave characteristics in atrial fibrillation recurrence and tachycardia-induced cardiomyopathy after catheter ablation |
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