title: Changes in Electrocardiographic P Wave Parameters after Cryoballoon Ablation and Their Association with Atrial Fibrillation Recurrence.
abstract: BACKGROUND
  Changes in P wave parameters after circumferential pulmonary vein isolation (CPVI) have been previously identified. In this study, we aimed to determine the changes in P wave parameters surface electrocardiogram (ECG) after cryoballoon ablation (CBA) for atrial fibrillation (AF) and evaluate their relationship with AF recurrence.
  
  
  METHODS
  Sixty-one patients (mean age 53 ± 11 years, 50.8% male) with paroxysmal AF who underwent CBA were enrolled. A surface ECG was obtained from all patients immediately before the procedure, and repeated 12 hours after the procedure. P wave amplitude (Pamp), P wave duration (Pwd), and P wave dispersion (Pdis) values in preprocedural and postprocedural ECGs were measured and compared. Recurrence rates of AF in 3, 6, and 9 months following ablation were recorded for all patients. Changes in P wave parameters were compared between patients with and without AF recurrence.
  
  
  RESULTS
  Compared to preprocedural measurements, Pamp (from 0.58 ± 0.18 mV at baseline to 0.48 ± 0.17 mV, P < 0.001), Pwd (from 109.72 ± 18.43 ms at baseline to 91.36 ± 22.53 ms, P < 0.001), and Pdis (from 55.44 ± 20.45 ms at baseline to 45.30 ± 15.31 ms, P < 0.001) were significantly decreased after CBA. The difference in Pamp between pre- and postprocedural values (∆Pamp) was significantly higher in patients without AF recurrence compared to those with recurrence (0.10 ± 0.06 mV vs 0.04 ± 0.01 mV, P = 0.002). There was no difference in Pwd difference (∆Pwd) and Pdis difference (∆Pdis) between patients with and without AF recurrence (P > 0.05).
  
  
  CONCLUSIONS
  Pamp, Pwd, and Pdis parameters exhibited significant decrease after CBA compared to preprocedural measurements. Decreased Pamp was shown to be a predictor for good clinical outcomes following CBA.
authors.affiliation: Faculty of Medicine, Cardiology Department, Medipol University, Istanbul, Turkey. filizkizilirmak@hotmail.com.
authors.forename: Filiz
authors.initials: F
authors.lastname: Kizilirmak
authors.affiliation: Faculty of Medicine, Cardiology Department, Medipol University, Istanbul, Turkey.
authors.forename: Gultekin Gunhan
authors.initials: GG
authors.lastname: Demir
authors.affiliation: Faculty of Medicine, Cardiology Department, Medipol University, Istanbul, Turkey.
authors.forename: Tayyar
authors.initials: T
authors.lastname: Gokdeniz
authors.affiliation: Faculty of Medicine, Cardiology Department, Medipol University, Istanbul, Turkey.
authors.forename: Haci Murat
authors.initials: HM
authors.lastname: Gunes
authors.affiliation: Faculty of Medicine, Cardiology Department, Medipol University, Istanbul, Turkey.
authors.forename: Beytullah
authors.initials: B
authors.lastname: Cakal
authors.affiliation: Faculty of Medicine, Cardiology Department, Medipol University, Istanbul, Turkey.
authors.forename: Ekrem
authors.initials: E
authors.lastname: Guler
authors.affiliation: Faculty of Medicine, Cardiology Department, Medipol University, Istanbul, Turkey.
authors.forename: İbrahim Oguz
authors.initials: İO
authors.lastname: Karaca
authors.affiliation: Faculty of Medicine, Cardiology Department, Medipol University, Istanbul, Turkey.
authors.forename: Mehmet Onur
authors.initials: MO
authors.lastname: Omaygenç
authors.affiliation: Kartal Kosuyolu Research and Education Hospital, Istanbul, Turkey.
authors.forename: Fatih
authors.initials: F
authors.lastname: Yılmaz
authors.affiliation: Faculty of Medicine, Cardiology Department, Medipol University, Istanbul, Turkey.
authors.forename: Fatih Erkam
authors.initials: FE
authors.lastname: Olgun
authors.affiliation: Faculty of Medicine, Cardiology Department, Medipol University, Istanbul, Turkey.
authors.forename: Fethi
authors.initials: F
authors.lastname: Kilicaslan
mesh_terms: D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000601:surgery*; D003452:Cryosurgery; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000503:physiopathology* / Q000601:surgery*; D012008:Recurrence; D015203:Reproducibility of Results; D014057:Tomography, X-Ray Computed
keywords: atrial arrhythmias; atrial fibrillation; electrocardiography; electrophysiology; noninvasive techniques