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Atrial late potentials are associated with atrial fibrillation recurrence after catheter ablation
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  • Daiki Saito,
  • Hidehira Fukaya,
  • Jun Oikawa,
  • Tetsuro Sato,
  • Gen Matsuura,
  • Yuki Arakawa,
  • Shuhei Kobayashi,
  • Yuki Shirakawa,
  • Naruya Ishizue,
  • Jun Kishihara,
  • Shinichi Niwano,
  • Junya Ako
Daiki Saito
Kitasato Daigaku Igakubu
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Hidehira Fukaya
Kitasato Daigaku Igakubu

Corresponding Author:[email protected]

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Jun Oikawa
Kitasato Daigaku Igakubu
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Tetsuro Sato
Kitasato Daigaku Igakubu
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Gen Matsuura
Kitasato Daigaku Igakubu
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Yuki Arakawa
Kitasato Daigaku Igakubu
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Shuhei Kobayashi
Kitasato Daigaku Igakubu
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Yuki Shirakawa
Kitasato Daigaku Igakubu
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Naruya Ishizue
Kitasato Daigaku Igakubu
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Jun Kishihara
Kitasato Daigaku Igakubu
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Shinichi Niwano
Kitasato Daigaku Igakubu
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Junya Ako
Kitasato Daigaku Igakubu
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Abstract

Introduction: Few non-invasive parameters have been identified for predicting atrial fibrillation (AF) recurrence after catheter ablation (CA). This study aimed to assess the association between AF recurrence and atrial late potentials (ALP) measured using P-wave signal-averaged electrocardiography (P-SAECG). Methods and results: Consecutive patients with paroxysmal AF who underwent first CA at our institution between August 2015 and August 2019 were enrolled. P-SAECG was performed before CA. Two ALP parameters were evaluated: root mean square voltage during the terminal 20 ms (RMS 20) and P-wave duration (PWD). Positive ALP was defined as an RMS 20 <2.2 µV and/or a PWD >115 ms. Patients were divided into the Recurrence and Non-recurrence groups based on AF recurrence at the 1-year follow-up after CA. Of 190 patients (age: 65±11 years, 37% women) enrolled in this study, 21 (11%) had AF recurrence. Positive ALP rate was significantly higher in the Recurrence group than in the Non-Recurrence group (86% vs. 64%, P=0.04) despite there being no differences in other baseline characteristics between the two groups. In the multivariate analysis, positive ALP was an independent predictor of AF recurrence (odds ratio: 3.83, 95% confidence interval: 1.05–14.1, P=0.04). Conclusion: Positive ALP on pre-CA P-SAECG was associated with AF recurrence after CA.