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 (RMS20) and P-wave
duration (PWD). Positive ALP was
defined as an RMS20 <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.
Keywords: atrial fibrillation; atrial late potentials; catheter
ablation; pulmonary vein isolation; recurrence