Risk Stratification for Recurrent Tachyarrhythmias in Patients with Paroxysmal Atrial Fibrillation and Flutter: Role of Signal Averaged Electrocardiogram and Echocardiography

The value of signal‐averaged P‐wave electrocardiogram and echocardiography for predicting recurrent atrial tachyarrhythmias was prospectively investigated in 60 patients presenting with paroxysmal atrial fibrillation or flutter. All patients were followed up for 1 year after restoration of sinus rhythm. A stepwise discriminant function analysis was used to identify variables predicting recurrent atrial tachyarrhythmias. Analyzed variables included signal‐averaged P‐wave duration in 3 bipolar orthogonal leads (X,Y,Z) and their vector magnitude, as well as left and right atrial dimensions and volumes. During follow‐up, 25 patients had recurrent atrial tachyarrhythmias, while 35 did not. Using discriminant function analysis, the left atrial antero‐superior dimension was found to be the only variable predicting the recurrence of atrial tachyarrhythmias (p