Atrial late potentials are associated with atrial fibrillation recurrence after catheter ablation

• Published in: Journal of arrhythmia Vol. 38; no. 6; pp. 991 - 996
• Main Authors: Saito, Daiki, Fukaya, Hidehira, Oikawa, Jun, Sato, Tetsuro, Matsuura, Gen, Arakawa, Yuki, Kobayashi, Shuhei, Shirakawa, Yuki, Ishizue, Naruya, Kishihara, Jun, Niwano, Shinichi, Ako, Junya
• Format: Journal Article
• Language: English
• Published: Japan John Wiley & Sons, Inc 01.12.2022; John Wiley and Sons Inc; Wiley
• Subjects: Ablation; Ablation (Surgery); Analysis; Atrial fibrillation; atrial late potentials; Body mass index; Cardiac arrhythmia; catheter ablation; Catheters; Electrocardiogram; Electrocardiography; Enrollments; Esophagus; Heart failure; Original; Patients; pulmonary vein isolation; recurrence; Regression analysis; atrial late potentials; recurrence; atrial fibrillation; catheter ablation; pulmonary vein isolation
• ISSN: 1880-4276; 1883-2148
• DOI: 10.1002/joa3.12786

Background Previous studies have identified noninvasive methods for predicting atrial fibrillation (AF) recurrence after catheter ablation (CA). We assessed the association between AF recurrence and atrial late potentials (ALPs), which were measured using P‐wave signal‐averaged electrocardiography (P‐SAECG). Methods Consecutive patients with paroxysmal AF who underwent their first CA at our institution between August 2015 and August 2019 were enrolled. P‐SAECG was performed before CA. Two ALP parameters were evaluated: the root‐mean‐square voltage during the terminal 20 ms (RMS20) and the P‐wave duration (PWD). Positive ALPs were defined as an RMS20 <2.2 μV and/or a PWD >115 ms. Patients were allocated to either the recurrence or nonrecurrence group based on the presence of AF recurrence at the 1‐year follow‐up post‐CA. Results Of the 190 patients (age: 65 ± 11 years, 37% women) enrolled in this study, 21 (11%) had AF recurrence. The positive ALP rate was significantly higher in the recurrence group than in the nonrecurrence group (86% vs. 64%, p = .04), despite the absence of 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 = .04). Conclusions Positive ALP on pre‐CA P‐SAECG is associated with AF recurrence after CA. P‐wave signal‐averaged electrocardiography (P‐SAECG) findings could indicate atrial fibrosis, i.e., an arrhythmogenic substrate in patients with AF. We evaluated the association between AF recurrence after catheter ablation (CA) and atrial late potentials (ALPs), which were measured using P‐SAECG. The positive ALP rate was significantly higher in the Recurrence group than in the non‐Recurrence group (86% vs. 64%, p = .04). 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 = .04).