PDF(Pubmed)
Abstract：
UNASSIGNED: Outcomes of catheter ablation for non-paroxysmal atrial fibrillation (AF) remain suboptimal. Non-invasive stratification of patients based on the presence of atrial cardiomyopathy (ACM) could allow to identify the best responders to pulmonary vein isolation (PVI).
UNASSIGNED: Observational multicentre retrospective study in patients undergoing cryoballoon-PVI for non-paroxysmal AF. The duration of amplified P-wave (APW) was measured from a digitally recorded 12-lead electrocardiogram during the procedure. If patients were in AF, direct-current cardioversion was performed to allow APW measurement in sinus rhythm. An APW cut-off of 150 ms was used to identify patients with significant ACM. We assessed freedom from arrhythmia recurrence at long-term follow-up in patients with APW ≥ 150 ms vs. APW < 150 ms.
UNASSIGNED: We included 295 patients (mean age 62.3 ± 10.6), of whom 193 (65.4%) suffered from persistent AF and the remaining 102 (34.6%) from long-standing persistent AF. One-hundred-forty-two patients (50.2%) experienced arrhythmia recurrence during a mean follow-up of 793 ± 604 days. Patients with APW ≥ 150 ms had a significantly higher recurrence rate post ablation compared to those with APW < 150 ms (57.0% vs. 41.6%; log-rank p < 0.001). On a multivariable Cox-regression analysis, APW≥150 ms was the only independent predictor of arrhythmia recurrence post ablation (HR 2.03 CI95% 1.28-3.21; p = 0.002).
UNASSIGNED: APW duration predicts arrhythmia recurrence post cryoballoon-PVI in persistent and long-standing persistent AF. An APW cut-off of 150 ms allows to identify patients with significant ACM who have worse outcomes post PVI. Analysis of APW represents an easy, non-invasive and highly reproducible diagnostic tool which allows to identify patients who are the most likely to benefit from PVI-only approach.
UNASSIGNED: Observational multicentre retrospective study in patients undergoing cryoballoon-PVI for non-paroxysmal AF. The duration of amplified P-wave (APW) was measured from a digitally recorded 12-lead electrocardiogram during the procedure. If patients were in AF, direct-current cardioversion was performed to allow APW measurement in sinus rhythm. An APW cut-off of 150 ms was used to identify patients with significant ACM. We assessed freedom from arrhythmia recurrence at long-term follow-up in patients with APW ≥ 150 ms vs. APW < 150 ms.
UNASSIGNED: We included 295 patients (mean age 62.3 ± 10.6), of whom 193 (65.4%) suffered from persistent AF and the remaining 102 (34.6%) from long-standing persistent AF. One-hundred-forty-two patients (50.2%) experienced arrhythmia recurrence during a mean follow-up of 793 ± 604 days. Patients with APW ≥ 150 ms had a significantly higher recurrence rate post ablation compared to those with APW < 150 ms (57.0% vs. 41.6%; log-rank p < 0.001). On a multivariable Cox-regression analysis, APW≥150 ms was the only independent predictor of arrhythmia recurrence post ablation (HR 2.03 CI95% 1.28-3.21; p = 0.002).
UNASSIGNED: APW duration predicts arrhythmia recurrence post cryoballoon-PVI in persistent and long-standing persistent AF. An APW cut-off of 150 ms allows to identify patients with significant ACM who have worse outcomes post PVI. Analysis of APW represents an easy, non-invasive and highly reproducible diagnostic tool which allows to identify patients who are the most likely to benefit from PVI-only approach.
摘要：
■非阵发性心房颤动(AF)的导管消融结果仍不理想。根据心房心肌病（ACM）的存在对患者进行非侵入性分层可以确定对肺静脉隔离（PVI）的最佳反应者。
■接受非阵发性房颤冷冻球囊PVI患者的多中心观察性回顾性研究。在手术过程中，根据数字记录的12导联心电图测量了放大的P波（APW）的持续时间。如果患者处于房颤状态,我们进行了直流电复律以测量窦性心律的APW.150ms的APW截止值用于识别具有显著ACM的患者。我们评估了APW≥150ms患者长期随访中无心律失常复发的情况与APW<150ms。
■我们包括295名患者（平均年龄62.3±10.6），其中193例（65.4%）患有持续性房颤，其余102例（34.6%）患有长期持续性房颤。在平均793±604天的随访中，有142例患者（50.2％）出现了心律失常复发。与APW<150ms的患者相比，APW≥150ms的患者消融后复发率明显更高（57.0%vs.41.6%；对数秩p<0.001)。在多变量Cox回归分析中，APW≥150ms是消融后心律失常复发的唯一独立预测因子(HR2.03CI95%1.28-3.21;p=0.002)。
■APW持续时间可预测持续性和长期持续性房颤患者冷冻球囊PVI后的心律失常复发。150ms的APW截止允许识别患有显著ACM的患者,其在PVI后具有更差的结果。分析APW代表了一个简单的，非侵入性和高度可重复性的诊断工具，可以识别最有可能从仅PVI方法中受益的患者。
■接受非阵发性房颤冷冻球囊PVI患者的多中心观察性回顾性研究。在手术过程中，根据数字记录的12导联心电图测量了放大的P波（APW）的持续时间。如果患者处于房颤状态,我们进行了直流电复律以测量窦性心律的APW.150ms的APW截止值用于识别具有显著ACM的患者。我们评估了APW≥150ms患者长期随访中无心律失常复发的情况与APW<150ms。
■我们包括295名患者（平均年龄62.3±10.6），其中193例（65.4%）患有持续性房颤，其余102例（34.6%）患有长期持续性房颤。在平均793±604天的随访中，有142例患者（50.2％）出现了心律失常复发。与APW<150ms的患者相比，APW≥150ms的患者消融后复发率明显更高（57.0%vs.41.6%；对数秩p<0.001)。在多变量Cox回归分析中，APW≥150ms是消融后心律失常复发的唯一独立预测因子(HR2.03CI95%1.28-3.21;p=0.002)。
■APW持续时间可预测持续性和长期持续性房颤患者冷冻球囊PVI后的心律失常复发。150ms的APW截止允许识别患有显著ACM的患者,其在PVI后具有更差的结果。分析APW代表了一个简单的，非侵入性和高度可重复性的诊断工具，可以识别最有可能从仅PVI方法中受益的患者。
