Atrial late potentials are associated with atrial fibrillation
recurrence after catheter ablation
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.