Characteristics of QRS complex duration on electrocardiogram in patients with atrial fibrillation and its relationship with arrhythmia after catheter radiofrequency ablation

Wang Zhiqin; Zhang Dayong; Xu Min; Yin Yangao

doi:10.3760/j.issn.1673-4777.2026.01.003

Abstract：Objective To explore the characteristics of QRS complex duration in patients with atrial fibril-lation and its relationship with recurrence after radiofrequency catheter ablation(RFCA).Methods A total of 188 patients with atrial fibrillation who underwent RFCA at Mianyang 404 Hospital from May 2022 to October 2024 were selected retrospectively.According to whether recurrence occurred within 3 months after surgery,the patients were divided into the recurrence group(n=52)and non-recurrence group(n=136).General data,QRS complex duration,ultrasonic parameters,and admission routine blood test indicators of the patients were collected.A hierarchical regression model was used to analyze the effects of different clinical characteristics on QRS complex duration.Multivariate Logistic regression was applied to analyze risk factors.Stratified interaction analysis was conducted to explore the effect of gender on the relationship between QRS complex duration and recurrence after RFCA.Receiver operating characteristic(ROC)curve was used to evaluate diagnostic efficacy.Restricted cubic spline(RCS)was employed to analyze the dose-response relationship between QRS complex duration and the risk of recurrence after RFCA.Results Hierarchical regression analysis showed that electrocardiographic f-wave pattern,brain natriuretic peptide(BNP),homocysteine(Hey),left atrial diameter(LAD),and left ventricular ejection fraction(LVEF)all had significant effects on QRS complex duration(all P＜0.05).Multivariate analysis revealed that electrocardiographic f-wave pattern,BNP,Hey,QRS complex duration,LAD,and LVEF were independent influencing factors for recurrence in atrial fibrillation patients after RFCA(all P＜0.05).Interaction test analysis indicated that gender had no impact on the relationship between QRS complex duration and recurrence after RFCA(Pinteraction＞0.05).The risk of postoperative recurrence in the high-risk group of QRS complex duration(＞150 ms)was 68.8％(22/32),with an interval likelihood ratio of 4.400.ROC curve analysis results showed that the area under the curve of QRS complex duration for diagnosing the risk of recurrence after RFCA was 0.753.RCS analysis demonstrated that there was a non-linear dose-response relationship between QRS complex duration and the risk of recurrence in atrial fibrillation patients after RFCA(P＜0.05).Conclusions Prolonged QRS complex duration is an independent risk factor for recurrence in patients with atrial fibrillation after RFCA.Preoperative measurement of QRS complex duration can effectively identify high-risk patients and provide a reference for individualized postoperative management.