Predictive value of atrial conduction time detected by intracadiac electrogram to atrial fibrillation recurrence

Luo Fangyuan; Wang Zhe; Zhang Yuekun; Chen Yingwei; Sun Liping; Chen Xiaojie; Dong Jianzeng

doi:10.3969/j.issn.1674-4055.2023.08.08

Abstract：Objective To discuss the predictive value of atrial conduction time detected by using intracadiac electrogram(IEGM)to recurrence of persistent atrial fibrillation(PeAF)after radiofrequency ablation(RFA).Methods PeAF patients(n=178)received firstly RFA were chosen from Jan.2020 to Jan.2021.The total atrial conduction time(P-CSd),right atrial conduction time(P-CSp)and maximum P-wave duration on body surface electrocardiogram(MPWD)were detected by using CARTO3 system.The patients were followed up in outpatient clinic or by telephone after the operation for 1 month,and 3,6,9 and 12 months.The influence factors of AF recurrence were analyzed taken postoperative AF recurrence as outcome.Results There were 58 cases of AF re recurrence(34.1%)after the patients followed up for 1 y.The percentage of patients with AF course>5,left atrial diameter(LAD),P-CSd,P-CSp and MPWD were all higher in recurrence group than those in non-recurrence group(P<0.05).The results of COX regression analysis showed that P-CSd(HR=1.024,95%CI:1.012～1.036,P<0.001)and MPWD(HR=1.017,95%CI:1.002～1.032,P=0.023)were risk factors taken BMI,AF course and LAD as correction factors.The results of ROC curve analysis showed that P-CSd had higher diagnostic value than MPWD,and AUC was 0.703(95%CI:0.620～0.785).When the cutoff value was taken as 113.5 ms,the sensitivity was 62.1%and specificity was 67.0%.The results of Kaplan-Meier survival curve analysis showed that recurrence rate was higher in group of P-CSd≥113.5 ms than that in group of P-CSd<113.5 ms(P<0.001).Conclusion The prolongation of P-CSd detected by using IEGM is an independent risk factor of PeAF recurrence after RFA,and P-CSd≥113.5 ms has a higher value of predicting PeAF recurrence after RFA.