%0 Journal Article
%T Amplified sinus-P-wave analysis predicts outcomes of cryoballoon ablation in patients with persistent and long-standing persistent atrial fibrillation: A multicentre study.
%A Creta A
%A Venier S
%A Tampakis K
%A Providencia R
%A Sunny J
%A Defaye P
%A Earley MJ
%A Finlay M
%A Hunter RJ
%A Lambiase PD
%A Papageorgiou N
%A Schilling RJ
%A Sporton S
%A Andrikopoulos G
%A Deschamps E
%A Albenque JP
%A Cardin C
%A Combes N
%A Combes S
%A Vinolas X
%A Moreno-Weidmann Z
%A Huang T
%A Eichenlaub M
%A Müller-Edenborn B
%A Arentz T
%A Jadidi AS
%A Boveda S
%J Front Cardiovasc Med
%V 10
%N 0
%D 2023
%M 37051067
%F 5.846
%R 10.3389/fcvm.2023.1110165
%X <B>UNASSIGNED: </B>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).<BR><B>UNASSIGNED: </B>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.<BR><B>UNASSIGNED: </B>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).<BR><B>UNASSIGNED: </B>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.