Abstract 15976: A New Electrocardiographic Marker for Recurrence of Atrial Fibrillation After Electrical Cardioversion
Backgrouds: Early recurrence of atrial fibrillation (AF) is common following successful electrical cardioversion (ECV). We hypothesized that recurrence of AF is related to impaired electrical conduction of Buchman’s Bundle, which may potentially be attributed to biphasic P wave morphology in III, aVf leads.
Methods: Consecutive 178 persistent AF patients who were to undergo ECV were enrolled, and evaluated for recurrence of AF after 1 month after ECV. Patients with open-heart surgery, history of catheter ablation, and an unsuccessful ECV were excluded. P wave duration and dispersion, and P wave morphology were evaluated by 12-lead ECG immediately after ECV. The parameters of transthoracic echocardiography were also evaluated before ECV.
Results: After exclusion criteria were applied, 88 patients were investigated. One month after ECV, 40 (45%) patients maintained sinus rhythm. Compared with the non-recurrence group, those with recurrent AF had significantly greater number of the patients with biphasic P wave morphology in both III, aVF leads (27% vs 10% P= 0.04, sensitivity 30%, specifity 92%), greater P wave dispersion (54 ± 17 vs 46 ± 12 ms, P= 0.02), and longer undergoing AF periods (40 ± 45 vs 20 ± 18 months, P= 0.006). Biphasic P wave morphology in both III, aVF leads were not associated with structural parameters such as left atrial diameter, left atrial area.
Conclusions: The risk of AF recurrence after ECV can be predicted by biphasic P wave morphology in III, aVF leads.
Author Disclosures: Y. Fujimoto: None. K. Yodogawa: None. K. Takahashi: None. I. Tsuboi: None. T. Yamamoto: None. Y. Iwasaki: None. M. Hayashi: None. W. Shimizu: None.
- © 2016 by American Heart Association, Inc.