title: P wave dispersion predicts recurrence of paroxysmal atrial fibrillation in patients with atrioventricular nodal reentrant tachycardia treated with radiofrequency catheter ablation.
abstract: BACKGROUND
  Paroxysmal atrial fibrillation (AF) recurs in up to one-third of patients with atrioventricular nodal reentrant tachycardia (AVNRT) treated with slow pathway ablation. Therefore, identification of patients at risk for recurrence of AF after slow pathway ablation is important because of the necessity for additional therapies. The purpose of this study was to determine whether successful slow pathway ablation influences P wave parameters and whether these parameters predict the recurrence of paroxysmal AF in patients with both AVNRT and paroxysmal AF after ablation.
  
  
  METHODS
  Thirty-six patients with AVNRT and documented paroxysmal AF (Group 1) were compared to 36 age-matched controls with AVNRT only (Group 2). P wave durations and P dispersion were measured before and after ablation.
  
  
  RESULTS
  No significant differences were observed between P wave parameters observed before and after ablation. Maximum P wave durations (Pmax) and P dispersion (Pdisp) were significantly higher in Group 1 than in Group 2 (P < 0.001 for both) whereas minimum P wave durations did not differ between groups, both before and after ablation. Ten patients (28%) in Group-1 had recurrence of AF during a mean follow-up of 34 +/- 11 months. Univariate predictors of AF recurrence were Pdisp > or =35.5 ms (P < 0.010), left atrial diameter >40 mm (P < 0.010), mitral or aortic calcification (P < 0.010), Pmax > or =112 ms (P < 0.050), valvular heart disease (P < 0.050), and atrial vulnerability (induction of AF lasting >30 second) after ablation (P < 0.050). However, only Pdisp > or =35.5 ms (P < 0.050) and left atrial diameter >40 mm (P < 0.010) were independent predictors of AF recurrences.
  
  
  CONCLUSIONS
  This study suggests that P wave dispersion could identify patients with AVNRT susceptible to recurrence of AF after slow pathway ablation.
authors.affiliation: Gulhane Military Medical Academy, Department of Cardiology, Ankara, Turkey. dramasyali@yahoo.com
authors.forename: Basri
authors.initials: B
authors.lastname: Amasyali
authors.forename: Sedat
authors.initials: S
authors.lastname: Kose
authors.forename: Kudret
authors.initials: K
authors.lastname: Aytemir
authors.forename: Ayhan
authors.initials: A
authors.lastname: Kilic
authors.forename: Hasan
authors.initials: H
authors.lastname: Turhan
authors.forename: Turgay
authors.initials: T
authors.lastname: Celik
authors.forename: Hurkan
authors.initials: H
authors.lastname: Kursaklioglu
authors.forename: Atila
authors.initials: A
authors.lastname: Iyisoy
authors.forename: Cengiz
authors.initials: C
authors.lastname: Ozturk
authors.forename: Ersoy
authors.initials: E
authors.lastname: Isik
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology / Q000517:prevention & control*; D017115:Catheter Ablation; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*