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A noninvasive index of atrial remodeling in patients with paroxysmal and persistent atrial fibrillation: a pilot study.

Abstract：

PURPOSE:This study aims to develop a noninvasive atrial remodeling index (RI) to separate patients presenting paroxysmal atrial fibrillation (ParAF) from those with sustained persistent atrial fibrillation (PerAF), that is, AF episodes interrupted 7 days or more after the onset. METHODS:Signal-averaged P-wave duration (SAPWd) and left atrial anteroposterior diameter (LADd) were measured in 33 ParAF patients, in 26 sustained PerAF patients, and in 18 control subjects. By using SAPWd and LADd, a dichotomous (0/1) RI was created. A logistic regression model on the probability of having a sustained PerAF vs a ParAF episode was estimated, including the RI, sex, age, and cardiac comorbidities as covariates. RESULTS:Signal-averaged P-wave duration was significantly longer in sustained PerAF (153 ± 15 milliseconds) than in ParAF patients (142 ± 13 milliseconds, P < .001) and in both ParAF and sustained PerAF groups vs control group (123 ± 7 milliseconds, P < .001). Left atrial anteroposterior diameter was larger both in sustained PerAF (43 ± 6 mm) vs ParAF patients (38 ± 5 mm, P = .002) and in sustained PerAF group vs control group (38 ± 2 mm, P = .004), but no differences were observed between ParAF patients and controls (P = .6). A 12-fold increase (odds ratio, 11.8; 95% confidence interval, 2.2-63.5) in the odds of having a sustained PerAF vs a ParAF episode was observed in patients with RI equal to 1. CONCLUSIONS:P-wave duration and left atrium diameter enabled to define a noninvasive atrial RI to separate patients with ParAF from those with sustained PerAF. This could be a useful tool to select a suitable strategy for AF treatment.

journal_name

J Electrocardiol

journal_title

Journal of electrocardiology

authors

Vincenti A,Rota M,Spinelli M,Corciulo M,De Ceglia S,Rovaris G,Antolini L,Genovesi S

doi

10.1016/j.jelectrocard.2011.08.005

subject

Has Abstract

pub_date

2012-03-01 00:00:00

pages

109-15

issue

2

eissn

0022-0736

issn

1532-8430

pii

S0022-0736(11)00307-4

journal_volume

45

pub_type

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