Prediction Of Outcome Of Radiofrequency Catheter Ablation For Paroxysmal Atrial Fibrillation By The Changes Of P-wave Correlated Parameters After Circumferential Pulmonary Vein Isolation

Objective: The study is to evaluate whether the changes of p-wave parameters on electrocardiography could predict the recurrences in paroxysmal atrial fibrillation(AF) patients who underwent circumferential pulmonary veins isolation(CPVI).Methods: We enrolled 53 consecutive AF patients who first time underwent CPVI for symptomatic drug-refractory paroxysmal AF. The patients were evaluated to determine their clinical history and then underwent physical examination and transthoracic and trans-esophageal echocardiography(TEE) to exclude thrombosis in left atrial. The patients also underwent pulmonary veins CT to clear pulmonary veins’ anatomy relationship and diameter. The radiofrequency ablation was performed guiding by Carto3 system. The individually ablation strategy is circumferential pulmonary vein isolation. For each patient, a Standard 12-lead surface ECG record was taken by the MAC5500 Electrocardiograph that produced by GE company before and after the ablation procedures. And then export ECG data from MUSE System. Each patient was followed-up by telephone call, 24- hours Dynamic Electrocardiography and a 12-lead ECG was recorded for confirming whether AF recurrent. During a 5 to 14 month follow-up period,patients was divided into recurrent group and successful group. Data were analyzed with SPSS17.0 statistical analysis software. We compared the changes of P wave related parameter between the successful group and recurrent group and evaluate whether P wave related parameters can be predictive marker of AF recurrences in patients who underwent RFCA procedures with circumferential pulmonary vein isolation(CPVI).Results: 1. The changes of P-wave parameters(including the duration, amplitude, area) before and after CPVI in recurrent group was no statistically significant differences. 2. Before CPVI,p-wave duration of I, V1, V2 lead in successful group were lower than the recurrent group(P < 0.05), the difference was statistically significant.3. The amplitude(from 87.41 + 24.02 m V to 69.78 + 30.18 m V, P=0.01) and area(from 247.11 + 100.22 m V * ms to 197.54 + 88.54 m V * ms, P=0.027) were decreased in successful group, the difference was statistically significant.Conclusion: Standard 12-lead electrocardiography P wave of I、V1、V2 leads correlated parameters can be predictive markers of AF recurrences in patients who underwent RFCA procedures with circumferential pulmonary vein isolation(CPVI).