Electrocardiographic predictors of early recurrence of atrial fibrillation

Abstract Background Electrical cardioversion (ECV) is an effective method for restoring sinus rhythm after atrial fibrillation (AF). However, early recurrence of AF occurs in a significant number of patients after ECV. This study aimed to identify electrocardiographic (ECG) predictors of early AF re...

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Autores principales:	Ji‐Hoon Choi, Hee‐Jin Kwon, Hye Ree Kim, Seung‐Jung Park, June Soo Kim, Young Keun On, Kyoung‐Min Park
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	atrial fibrillation cardioversion P‐terminal force P‐wave duration recurrence Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/9ba75d74971946e5bd5ad784ca23d280
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spelling	oai:doaj.org-article:9ba75d74971946e5bd5ad784ca23d2802021-11-12T11:40:14ZElectrocardiographic predictors of early recurrence of atrial fibrillation1542-474X1082-720X10.1111/anec.12884https://doaj.org/article/9ba75d74971946e5bd5ad784ca23d2802021-11-01T00:00:00Zhttps://doi.org/10.1111/anec.12884https://doaj.org/toc/1082-720Xhttps://doaj.org/toc/1542-474XAbstract Background Electrical cardioversion (ECV) is an effective method for restoring sinus rhythm after atrial fibrillation (AF). However, early recurrence of AF occurs in a significant number of patients after ECV. This study aimed to identify electrocardiographic (ECG) predictors of early AF recurrence after ECV. Methods A total of 272 patients with persistent AF undergoing successful ECV were consecutively enrolled in this study. We investigated clinical, echocardiographic, and ECG data. The 12‐lead ECG parameters were measured during sinus rhythm right after ECV using a digital caliper. The early AF recurrence was defined as recurrence within 2 months. Results Of the 272 patients, 165 patients (60.7%) experienced an early AF recurrence. Maximum P‐wave duration (PWD) in limb leads (OR: 1.086; 95% CI: 1.019–1.157; p = .012) and P‐terminal force (PTF) in V1 (OR: 1.019; 95% CI: 1.004–1.033; p = .011) were independent predictors of early AF recurrence after ECV. The optimal cutoff value of the maximum PWD in limb leads for predicting early AF recurrence was 134 ms, characterized by 90.3% sensitivity and 72.0% specificity. Likewise, the optimal cutoff value of PTF in V1 was 50 ms × mm, characterized by 80.0% sensitivity and 64.5% specificity. Conclusion A longer PWD (>134 ms) and a larger PTF (>50 ms × mm) were useful predictors of early recurrence of AF after successful ECV in clinical practice. A more effective rhythm control therapy such as catheter ablation or rate control strategy rather than a repeat ECV should be considered.Ji‐Hoon ChoiHee‐Jin KwonHye Ree KimSeung‐Jung ParkJune Soo KimYoung Keun OnKyoung‐Min ParkWileyarticleatrial fibrillationcardioversionP‐terminal forceP‐wave durationrecurrenceDiseases of the circulatory (Cardiovascular) systemRC666-701ENAnnals of Noninvasive Electrocardiology, Vol 26, Iss 6, Pp n/a-n/a (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	atrial fibrillation cardioversion P‐terminal force P‐wave duration recurrence Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	atrial fibrillation cardioversion P‐terminal force P‐wave duration recurrence Diseases of the circulatory (Cardiovascular) system RC666-701 Ji‐Hoon Choi Hee‐Jin Kwon Hye Ree Kim Seung‐Jung Park June Soo Kim Young Keun On Kyoung‐Min Park Electrocardiographic predictors of early recurrence of atrial fibrillation
description	Abstract Background Electrical cardioversion (ECV) is an effective method for restoring sinus rhythm after atrial fibrillation (AF). However, early recurrence of AF occurs in a significant number of patients after ECV. This study aimed to identify electrocardiographic (ECG) predictors of early AF recurrence after ECV. Methods A total of 272 patients with persistent AF undergoing successful ECV were consecutively enrolled in this study. We investigated clinical, echocardiographic, and ECG data. The 12‐lead ECG parameters were measured during sinus rhythm right after ECV using a digital caliper. The early AF recurrence was defined as recurrence within 2 months. Results Of the 272 patients, 165 patients (60.7%) experienced an early AF recurrence. Maximum P‐wave duration (PWD) in limb leads (OR: 1.086; 95% CI: 1.019–1.157; p = .012) and P‐terminal force (PTF) in V1 (OR: 1.019; 95% CI: 1.004–1.033; p = .011) were independent predictors of early AF recurrence after ECV. The optimal cutoff value of the maximum PWD in limb leads for predicting early AF recurrence was 134 ms, characterized by 90.3% sensitivity and 72.0% specificity. Likewise, the optimal cutoff value of PTF in V1 was 50 ms × mm, characterized by 80.0% sensitivity and 64.5% specificity. Conclusion A longer PWD (>134 ms) and a larger PTF (>50 ms × mm) were useful predictors of early recurrence of AF after successful ECV in clinical practice. A more effective rhythm control therapy such as catheter ablation or rate control strategy rather than a repeat ECV should be considered.
format	article
author	Ji‐Hoon Choi Hee‐Jin Kwon Hye Ree Kim Seung‐Jung Park June Soo Kim Young Keun On Kyoung‐Min Park
author_facet	Ji‐Hoon Choi Hee‐Jin Kwon Hye Ree Kim Seung‐Jung Park June Soo Kim Young Keun On Kyoung‐Min Park
author_sort	Ji‐Hoon Choi
title	Electrocardiographic predictors of early recurrence of atrial fibrillation
title_short	Electrocardiographic predictors of early recurrence of atrial fibrillation
title_full	Electrocardiographic predictors of early recurrence of atrial fibrillation
title_fullStr	Electrocardiographic predictors of early recurrence of atrial fibrillation
title_full_unstemmed	Electrocardiographic predictors of early recurrence of atrial fibrillation
title_sort	electrocardiographic predictors of early recurrence of atrial fibrillation
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/9ba75d74971946e5bd5ad784ca23d280
work_keys_str_mv	AT jihoonchoi electrocardiographicpredictorsofearlyrecurrenceofatrialfibrillation AT heejinkwon electrocardiographicpredictorsofearlyrecurrenceofatrialfibrillation AT hyereekim electrocardiographicpredictorsofearlyrecurrenceofatrialfibrillation AT seungjungpark electrocardiographicpredictorsofearlyrecurrenceofatrialfibrillation AT junesookim electrocardiographicpredictorsofearlyrecurrenceofatrialfibrillation AT youngkeunon electrocardiographicpredictorsofearlyrecurrenceofatrialfibrillation AT kyoungminpark electrocardiographicpredictorsofearlyrecurrenceofatrialfibrillation
_version_	1718430633367175168

Electrocardiographic predictors of early recurrence of atrial fibrillation

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