{Reference Type}: Journal Article
{Title}: Amplified sinus-P-wave analysis predicts outcomes of cryoballoon ablation in patients with persistent and long-standing persistent atrial fibrillation: A multicentre study.
{Author}: Creta A;Venier S;Tampakis K;Providencia R;Sunny J;Defaye P;Earley MJ;Finlay M;Hunter RJ;Lambiase PD;Papageorgiou N;Schilling RJ;Sporton S;Andrikopoulos G;Deschamps E;Albenque JP;Cardin C;Combes N;Combes S;Vinolas X;Moreno-Weidmann Z;Huang T;Eichenlaub M;Müller-Edenborn B;Arentz T;Jadidi AS;Boveda S;
{Journal}: Front Cardiovasc Med
{Volume}: 10
{Issue}: 0
{Year}: 2023
{Factor}: 5.846
{DOI}: 10.3389/fcvm.2023.1110165
{Abstract}: <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.