Predictive Value Of P-wave Parameters In Surface Electrocardiogram In Patients With Paroxysmal Atrial Fibrillation After Radiofrequency Catheter Ablation For Post-operation Recurrence

Objective:To investigate the predictive value of P wave parameters in body surface electrocardiogram for recurrence of atrial fibrillation(AF)in patients with paroxysmal AF after radiofrequency catheter ablation.Methods:Fifty-nine patients with paroxysmal AF underwent primary radiofrequency catheter ablation.The time limit,amplitude and dispersion of P wave were measured in each lead of 12 lead synchronized body electrocardiogram obtained before and 24 hours after the operation.The difference in each parameter was compared between groups of the patients with and without recurrence of AF,and those with significant difference were selected for further evaluation of their predictive value for recurrence of AF by multiple regression equation.Results:Recurrence of AF was found in 8(13.5%,recurrent group)and not in 51(86.5%,non-recurrent group)patients.The result of comparative analysis for P wave parameters showed that,the non-recurrent one was longer in P time limit in lead II,III and V5 before operation,the difference between the two groups was that the change of P wave time limit before and after operation in leads III was smaller than in the recurrence group.the non-recurrent one was longer in P wave amplitude in lead I,II and aVR before operation,the difference between the two groups was that the aVR lead in the non recurrence group was smaller than that in the recurrence group.The result of multiple regression analysis for the above parameters showed that both P wave amplitude in lead aVR and the change of P wave time limit before and after operation in lead III were independent risk factors for postoperative recurrence of AF(with OD of 0.951 and 0.961);ROC curve analysis found that the change of P wave time limit before and after operation in lead III had the highest diagnostic value,with the best diagnostic point at 18.40 ms where presented a sensitivity of 80% and specificity of 72.3%.Conclusions:Both P wave amplitude in lead aVR and the change of P wave time limits before and after operation in lead III have predictive values for postoperative recurrence of AF in patients with paroxysmal AF after radiofrequency catheter ablation,of which the later is better.