Characterization of Changes in P-Wave VCG Loops Following Pulmonary-Vein Isolation

Fecha de publicación: 09/03/2021 Fecha Ahead of Print: 09/03/2021

Autores de IIS La Fe

• Óscar Cano Pérez

  Autor

Participantes ajenos a IIS La Fe

• Ortigosa, Nuria
• Sandberg, Frida

Grupos

• Grupo de Investigación Clínica y Traslacional en Cardiología

  

  Investigador Principal

  Esther Roselló Lletí

Abstract

Atrial fibrillation is the most common type of cardiac arrhythmia in clinical practice. Currently, catheter ablation for pulmonary-vein isolation is a well-established treatment for maintaining sinus rhythm when antiarrhythmic drugs do not succeed. Unfortunately, arrhythmia recurrence after catheter ablation remains common, with estimated rates of up to 45%. A better understanding of factors leading to atrial-fibrillation recurrence is needed. Hence, the aim of this study is to characterize changes in the atrial propagation pattern following pulmonary-vein isolation, and investigate the relation between such characteristics and atrial-fibrillation recurrence. Fifty patients with paroxysmal atrial fibrillation who had undergone catheter ablation were included in this study. Time-segment and vectorcardiogram-loop-morphology analyses were applied to characterize P waves extracted from 1 min long 12-lead electrocardiogram segments before and after the procedure, respectively. Results showed that P-wave vectorcardiogram loops were significantly less round and more planar, P waves and PR intervals were significantly shorter, and heart rate was significantly higher after the procedure. Differences were larger for patients who did not have arrhythmia recurrences at 2 years of follow-up; for these patients, the pre- and postprocedure P waves could be identified with 84% accuracy.

Keywords

• vectorcardiogram (VCG); atrial fibrillation; P wave; pulmonary-vein isolation