The predictive value of 24-hour dynamic electrocardiogram for the recurrence of atrial fibrillation after radiofrequency ablation in patients with pre-excitation syndrome and atrial fibrillation

Cai Ling; Cheng Yao; Zhang Lei

doi:10.3760/j.issn.1673-4777.2024.10.002

Abstract：Objective To investigate the value of 24 h dynamic electrocardiogram in predicting the recurrence of atrial fibrillation in patients with pre-excitation syndrome(WPW)and atrial fibrillation after radiofrequency ablation.Methods Fifty-one WPW patients with atrial fibrillation recurrence 6 months after radiofrequency ablation(recurrence group)and 51 WPW patients without atrial fibrillation recurrence(non-recurrence group)were selected from August 2021 to September 2023 in the Department of Electrocardiogram Function,the First People's Hospital of Kashgar,Xinjiang Uygur Autonomous Region.The 24 h dynamic electrocardiogram[P wave amplitude,maximum P wave duration(Pmax),P wave dispersion(Pd)and P wave terminal potential(Ptf),PR interval,QT interval corrected for heart rate(QTc)and Tp-Te interval]were compared between the two groups before operation.Multivariate Iogistic regression model was used to analyze the influencing factors of atrial fibrillation recurrence after radiofrequency ablation in patients with WPW and atrial fibrillation.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of postoperative atrial fibrillation recurrence.Results The values of QTc,P wave amplitude,Pmax and Pd in recurrence group were higher than those in non-recurrence group,while Ptf was lower than that in non-recurrence group(all P＜0.05).The age,duration of disease,left atrial diameter and atrial fibrillation attack frequency before ablation in the recurrence group were higher than those in the non-recurrence group,and left ventricular ejection fraction(LVEF)was lower than that in the non-recurrence group(all P＜0.05).Logistic regression analysis showed that older age,high Pmax and Pd values,and low LVEF were independent risk factors for atrial fibrillation recurrence after radiofrequency ablation in WPW patients with atrial fibrillation(all P＜0.05).ROC curve showed that the areas under the curve(AUC)of Pmax and Pd alone to predict the recurrence of atrial fibrillation after radiofrequency ablation in WPW patients with atrial fibrillation were 0.809(95％confidence interval:0.769-0.838)and 0.811(95％confidence interval:0.770-0.875),the AUC of combined prediction was 0.918(95％confidence interval:0.878-0.949),and the combined prediction efficiency is better than the individual prediction efficiency(both P＜0.05).Conclusion The 24 h dynamic electrocardiogram is related to the recurrence of atrial fibrillation after radiofrequency ablation in patients with WPW and atrial fibrillation.The Pmax and Pd values of P-wave potential are the risk factors for recurrence of atrial fibrillation after radiofrequency ablation in patients with WPW and atrial fibrillation,and the combination of the two has high efficacy in predicting recurrence of atrial fibrillation after radiofrequency ablation.