title: P wave indices to predict atrial fibrillation recurrences post pulmonary vein isolation.
abstract: BACKGROUND
  P-wave indices are appealing markers for predicting atrial fibrillation (AF) recurrences post ablation.
  
  
  OBJECTIVE
  This study evaluates the value of P wave indices to predict recurrences post pulmonary vein isolation (PVI) in patients with paroxysmal AF.
  
  
  METHODS
  We selected 198 patients (57 ± 8 years, 150 males) with symptomatic drug-refractory paroxysmal AF undergoing PVI in our hospital. A 12-lead electrocardiogram was used to measure P wave duration in lead II, P wave terminal force (PWTF) in lead V1, P wave axis and dispersion.
  
  
  RESULTS
  During a follow-up of 9 ± 3 months, recurrences occurred in 60 (30.3%) patients. The patients that had AF recurrence had longer mean P wave duration (122.9 ± 10.3 vs 104.3 ± 14.2 ms, p < 0.001), larger P wave dispersion (40.7 ± 1.7 ms vs 36.6 ± 3.2 ms, p < 0.001). P wave duration > 125 ms has 60% sensitivity, 90% specificity, positive predictive value (PPV) of 72% and negative predictive value (NPV) of 83.7%, whereas P wave dispersion > 40 ms has 78% sensitivity, 67% specificity, PPV of 51% and NPV of 87.6% 48/66 (72.7%) patients with PWTF < -0.04 mm/second vs 12/132(9%) with PWTF > -0.04 mm/second showed recurrence of AF (p < 0.001). P wave axis was not different between two groups. On multivariate analysis, P wave indices were not independent from left atrial size and age.
  
  
  CONCLUSIONS
  P wave duration > 125 ms, P wave dispersion > 40 ms and PWTF in V1 < -0.04 mm/sec are good clinical predictors of AF recurrences post PVI in patients with paroxysmal atrial fibrillation; however they were not independent from left atrial size and age.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Salah
authors.forename: Shenghua
authors.initials: S
authors.lastname: Zhou
authors.forename: Qiming
authors.initials: Q
authors.lastname: Liu
authors.forename: Hui
authors.initials: H
authors.lastname: Yan
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D015415:Biomarkers / Q000032:analysis; D017115:Catheter Ablation / Q000379:methods; D004562:Electrocardiography / Q000592:standards*; D005260:Female; D006325:Heart Atria / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011667:Pulmonary Veins / Q000503:physiopathology / Q000601:surgery*; D012008:Recurrence; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers