Archives of the
Turkish Society of Cardiology
Original Article

An Effective Novel Index for Predicting the Recurrence of Atrial Fibrillation Ablation: P Wave Duration-to-Amplitude Ratio


Department of Cardiology, Uşak University Training and Research Hospital, Uşak, Turkey


Heart Rhythm Management Center, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey


Department of Cardiology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey


Department of Cardiology, Bornova Türkan Özilhan State Hospital, İzmir, Turkey


Department of Cardiology, Aydın Atatürk State Hospital, Aydın, Turkey


Ege Aritmi Medical Products Engineering, İzmir, Turkey

Archives of the Turkish Society of Cardiology 2022; 50: 498-504
DOI: 10.5543/tkda.2022.22416
Read: 582 Downloads: 120 Published: 29 June 2022

Objective: Atrial fibrillation is the most common arrhythmia observed in the clinical practice. Pulmonary vein isolation is a well established treatment option for atrial fibrillation but is limited by recurrence. Previous studies have demonstrated that abnormal P wave indices were associated with adverse atrial remodeling and its role in predicting atrial fibrillation recurrence. In the present study, we aimed to evaluate the place of a novel index as we named P wave duration-to-amplitude ratio in predicting the recurrence of atrial fibrillation.

Methods: Patients who underwent pulmonary vein isolation for symptomatic drug-resistant atrial fibrillation between January 2016 and March 2018 were retrospectively screened. A total of 111 patients were enrolled in the current study. P wave indices of the patients were calculated by precisely measuring the electrocardiogram traces recorded with an electrophysiology recording system.

Results: While P wave duration (129 ± 18.4 vs. 109 ± 15.7 ms, P <.001), P wave duration-toamplitude ratio (1072.7 ± 528.3 vs. 626.9 ± 368 ms/mV, P <.001), P wave peak time (65 ± 12 vs. 54 ± 10 ms, P <.001), and P wave dispersion (49 ± 14.1 vs. 27.9 ± 17 ms, P =.001) values were significantly higher in the atrial fibrillation recurrence (+) group, the P wave amplitude (0.12 ± 0.05 vs. 0.18 ± 0.02 mV, P <.001) value was found to be lower. A P wave duration-t o-amplitude ratiovalue of >830 ms/mV has 61.8% sensitivity and 88.4% specificity for the prediction of the atrial fibrillation recurrence (area of under the curve [AUC], 0.727).

Conclusion: P wave duration-to-amplitude ratio, which may be considered as an indicator of the temporal and electrical propagation of the P wave in the atria, can predict atrial fibrillation ablation recurrence.

Cite this article as: Doğduş M, Turan OE, Başkurt AA, et al. An effective novel index for predicting the recurrence of atrial fibrillation ablation: P wave duration-to-amplitude ratio. Turk Kardiyol Dern Ars. 2022;50(7):498-504.

ISSN 1016-5169 EISSN 1308-4488