title: Predictors of early recurrence and delayed cure after segmental pulmonary vein isolation for paroxysmal atrial fibrillation without structural heart disease.
abstract: BACKGROUND
  Early recurrence of atrial fibrillation (ERAF) and delayed cure are commonly observed after atrial fibrillation (AF) ablation. The purpose of this study was to determine the predictors of ERAF and delayed cure after a single pulmonary vein isolation (PVI) performed in paroxysmal AF patients without structural heart disease.
  
  
  RESULTS
  In 108 consecutive patients (93 men, 15 women; mean age 51 +/- 8 years) with paroxysmal AF and no structural heart disease, segmental PVI guided by a Lasso catheter was performed. Forty-one percent (44/108) AF patients had ERAF after a single PVI. Univariate analysis revealed that left atrial diameter (p = 0.004), age (p = 0.024) and P-wave dispersion (p = 0.045) were significantly related to ERAF. Logistic regression analysis revealed that left atrial enlargement was the only independent predictor of ERAF (odds ratio [OR] 1.17; 95% confidence interval [CI] 1.04-1.30, p = 0.006). Delayed cure occurred in 32% (14/44) patients with ERAF. P-wave dispersion (p = 0.001), left atrial diameter (p = 0.008) were significantly related to delayed cure. P-wave dispersion was the only independent predictive factor of delayed cure (OR 0.91; 95% CI 0.85-0.97, p = 0.004).
  
  
  CONCLUSIONS
  Elderly patients with left atrial enlargement and a high dispersion of P wave are susceptible to ERAF after a single PVI. Left atrial enlargement is the only independent predictor of ERAF. Among patients with ERAF, those with less P-wave dispersion and less left atrial diameter have a higher probability of delayed cure. P-wave dispersion can independently predict delayed cure.
authors.affiliation: Department of Cardiology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang, Wuhan, 430060, China. hong_j_wurm@163.com
authors.forename: Hong
authors.initials: H
authors.lastname: Jiang
authors.forename: Zhibing
authors.initials: Z
authors.lastname: Lu
authors.forename: Handong
authors.initials: H
authors.lastname: Lei
authors.forename: Dongdong
authors.initials: D
authors.lastname: Zhao
authors.forename: Bo
authors.initials: B
authors.lastname: Yang
authors.forename: Congxin
authors.initials: C
authors.lastname: Huang
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000517:prevention & control*; D017115:Catheter Ablation / Q000706:statistics & numerical data; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D011667:Pulmonary Veins / Q000601:surgery*; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D055502:Secondary Prevention; D016896:Treatment Outcome