Prediction of AF recurrence after CA using P-SAECG
Structural and electrical remodeling have been reported as the causes of
arrhythmias.14 Findings suggestive of dilatation on
non-invasive modalities such as echocardiography or computed tomography
could indicate structural remodeling of the atrium. Preoperative left
atrial diameter (LAD) has been reported to be associated with AF
recurrence after CA.15,16 Structural remodeling in the
form of LA enlargement is the most common arrhythmogenic substrate.
P-wave duration on surface 12-lead ECG has also been associated with AF
recurrence after CA.17,18 A long P-wave duration is
associated with an enlarged LA19 and atrial conduction
disturbance.20 We demonstrated that positive ALP was
an independent predictor of AF recurrence after CA, and there were no
significant differences in the LAD and P-wave duration on surface
12-lead ECG between the Recurrence and Non-Recurrence groups. This may
be because our study population only consisted of patients with
paroxysmal AF who had a short disease duration and in whom structural
remodeling might not have progressed. ALP could reflect subtle changes
in the atria that are not structural changes and do show up as changes
in the P-wave on 12-lead ECG. Based on the results of our study, we
speculate that ALP can reveal the progression of electrical remodeling
in patients without structural remodeling.