• J Chin Med Assoc · May 2022

    Dynamic changes in signal-averaged P wave after catheter ablation of atrial fibrillation.

    • Dony Yugo, Ming-Jen Kuo, Yu-Feng Hu, Chih-Min Liu, Yenn-Jiang Lin, Shih-Lin Chang, Li-Wei Lo, Tze-Fan Chao, Fa-Po Chung, Jo-Nan Liao, Ting-Yung Chang, Chin-Yu Lin, Ta-Chuan Tuan, Ling Kuo, Shin-Huei Liu, An Nu-Khanh Ton, Chheng Chhay, Ahmed Elimam, and Shih-Ann Chen.
    • Heart Rhythm Center, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
    • J Chin Med Assoc. 2022 May 1; 85 (5): 549-553.

    BackgroundThe comprehensive surveillance for interval changes in signal-averaged P-wave (SAPW) after pulmonary vein isolation (PVI) remains lacking. We aimed to analyze the SAPW parameters before and after PVI and explored their link to the left atrial electrical properties.MethodsEighteen patients with paroxysmal atrial fibrillation receiving primary catheter ablation were enrolled. SAPW parameters, including root mean square voltages in the last 40, 30, and 20 ms (RMS40, RMS30, and RMS20, respectively), the total P-wave (RMSt), the integral of P-wave potentials (Int-p), and P-wave duration (fPWD), were measured before and after PVI and correlated to the left atrial activation time (LAT) and mean left atrial voltage (LAV) from electro-anatomical mapping.ResultsCompared with the SAPW before PVI, fPWD (before vs after PVI: 144.1 ± 5.2 vs 135.1 ± 11.9 ms, p = 0.02), Int-p (687.4 ± 173.1 vs 559 ± 202.5 mVms, p = 0.01), and RMSt (6.44 ± 1.3 vs 5.44 ± 2.0 mV, p = 0.04) all decreased after PVI. RMS20, RMS30, and RMS40 showed no significant difference. Similarly, LAT (97.5 ± 9.3 vs 90.5 ± 9.3 ms, p = 0.008) and LAV (1.37 ± 0.27 vs 0.96 ± 0.31 mV, p = 0.001) decreased after PVI. Although consistent changes after PVI were observed between SAPW parameters and LAT or LAV, no linear correlation was observed among them.ConclusionThe consistent changes in SAPW and left atrial electrical properties after PVI suggest that SAPW may be used as a noninvasive tool to monitor the responses to PVI.Copyright © 2022, the Chinese Medical Association.

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