P-Wave Beat-to-Beat Analysis to Predict Atrial Fibrillation Recurrence after Catheter Ablation
Dimitrios Tachmatzidis,
Anastasios Tsarouchas,
Dimitrios Mouselimis,
Dimitrios Filos,
Antonios P. Antoniadis,
Dimitrios N. Lysitsas,
Nikolaos Mezilis,
Antigoni Sakellaropoulou,
Georgios Giannopoulos,
Constantinos Bakogiannis,
Konstantinos Triantafyllou,
Nikolaos Fragakis,
Konstantinos P. Letsas,
Dimitrios Asvestas,
Michael Efremidis,
Charalampos Lazaridis,
Ioanna Chouvarda,
Vassilios P. Vassilikos
Affiliations
Dimitrios Tachmatzidis
3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece
Anastasios Tsarouchas
3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece
Dimitrios Mouselimis
3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece
Dimitrios Filos
Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
Antonios P. Antoniadis
3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece
Dimitrios N. Lysitsas
St. Luke’s Hospital Thessaloniki, 552 36 Thessaloniki, Greece
Nikolaos Mezilis
St. Luke’s Hospital Thessaloniki, 552 36 Thessaloniki, Greece
Antigoni Sakellaropoulou
Electrophysiology Laboratory, 2nd Department of Cardiology, Evangelismos General Hospital of Athens, 106 76 Athens, Greece
Georgios Giannopoulos
3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece
Constantinos Bakogiannis
3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece
Konstantinos Triantafyllou
3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece
Nikolaos Fragakis
3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece
Konstantinos P. Letsas
Electrophysiology Laboratory, 2nd Department of Cardiology, Evangelismos General Hospital of Athens, 106 76 Athens, Greece
Dimitrios Asvestas
Electrophysiology Laboratory, 2nd Department of Cardiology, Evangelismos General Hospital of Athens, 106 76 Athens, Greece
Michael Efremidis
Electrophysiology Laboratory, 2nd Department of Cardiology, Evangelismos General Hospital of Athens, 106 76 Athens, Greece
Charalampos Lazaridis
3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece
Ioanna Chouvarda
Lab of Computing, Medical Informatics and Biomedical Imaging Technologies, School of Medicine, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
Vassilios P. Vassilikos
3rd Cardiology Department, Hippokrateion University Hospital, Aristotle University of Thessaloniki, 546 42 Thessaloniki, Greece
The identification of patients prone to atrial fibrillation (AF) relapse after catheter ablation is essential for better patient selection and risk stratification. The current prospective cohort study aims to validate a novel P-wave index based on beat-to-beat (B2B) P-wave morphological and wavelet analysis designed to detect patients with low burden AF as a predictor of AF recurrence within a year after successful catheter ablation. From a total of 138 consecutive patients scheduled for AF ablation, 12-lead ECG and 10 min vectorcardiogram (VCG) recordings were obtained. Univariate analysis revealed that patients with higher B2B P-wave index had a two-fold risk for AF recurrence (HR: 2.35, 95% CI: 1.24–4.44, p: 0.010), along with prolonged P-wave, interatrial block, early AF recurrence, female gender, heart failure history, previous stroke, and CHA2DS2-VASc score. Multivariate analysis of assessable predictors before ablation revealed that B2B P-wave index, along with heart failure history and a history of previous stroke or transient ischemic attack, are independent predicting factors of atrial fibrillation recurrence. Further studies are needed to assess the predictive value of the B2B index with greater accuracy and evaluate a possible relationship with atrial substrate analysis.
