Prolonged PR Interval Predicts Clinical Recurrence of Atrial Fibrillation After Catheter Ablation

Park, Junbeom; Kim, Tae Hoon; Lee, Jihei Sara; Park, Jin Kyu; Uhm, Jae Sun; Joung, Boyoung; Lee, Moon Hyoung; Pak, Hui Nam

doi:10.1161/jaha.114.001277

Cited by 51 publications

(47 citation statements)

References 38 publications

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“…PR interval prolongation in turn has been linked with advanced atrial remodeling and worse ablation outcome [26]. …”

Section: Discussionmentioning

confidence: 99%

Genomic Contributors to Rhythm Outcome of Atrial Fibrillation Catheter Ablation – Pathway Enrichment Analysis of GWAS Data

Husser¹,

Büttner²,

Ueberham³

et al. 2016

PLoS ONE

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BackgroundLeft atrial enlargement and persistent atrial fibrillation (AF) are well-known predictors for arrhythmia recurrence after AF catheter ablation (LRAF). In this study, by using pathway enrichment analysis of GWAS data, we tested the hypothesis that genetic pathways associated with these phenotypes are also associated with LRAF.MethodsSamples from 660 patients with paroxysmal (n = 370) or persistent AF (n = 290) undergoing de-novo AF catheter ablation were genotyped for ~1,000,000 SNPs. SNPs found to be significantly associated with left atrial diameter (LAD) or AF type were used for gene-based association tests in a systematic biological Knowledge-based mining system for Genome-wide Genetic studies (KGG). Associated genes were tested for pathway enrichment using WEB-based Gene SeT AnaLysis Toolkit (WebGestalt), the Gene Annotation Tool to Help Explain Relationships (GATHER) and the databases provided by Kyoto Encyclopedia of Genes and Genomes (KEGG). In a second step, the association of consistently enriched pathways and LRAF was tested.ResultsBy using sequential 7-day Holter ECGs, LRAF between 3 and 12 months was observed in 48% and was associated with LAD (B = 1.801, 95% CI 0.760–2.841, p = 1.0E-3) and persistent AF (OR = 2.1; 95% CI 1.567–2.931, p = 2.0E-6). WebGestalt (adj. p = 2.7E-22) and GATHER (adj. p = 5.2E-3) identified the calcium signaling pathway (hsa04020) as the only consistently enriched pathway for LAD, while the extracellular matrix (ECM) -receptor interaction pathway (hsa04512) was the only consistently enriched pathway for AF type (adj. p = 2.1E-15 in WebGestalt; adj. p = 9.3E-4 in GATHER). Both calcium signaling (adj. p = 2.2E-17 in WebGestalt; adj. p = 2.9E-2 in GATHER) and ECM-receptor interaction (adj. p = 1.2E-10 in WebGestalt; adj. p = 2.9E-2 in GATHER) were significantly associated with LRAF.ConclusionsCalcium signaling and ECM-receptor interaction pathways are associated with LAD and AF type and, in turn, with LRAF. Future and larger studies are necessary to replicate and apply these findings.

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“…PR interval prolongation in turn has been linked with advanced atrial remodeling and worse ablation outcome [26]. …”

Section: Discussionmentioning

confidence: 99%

Genomic Contributors to Rhythm Outcome of Atrial Fibrillation Catheter Ablation – Pathway Enrichment Analysis of GWAS Data

Husser¹,

Büttner²,

Ueberham³

et al. 2016

PLoS ONE

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“…There have been many studies regarding the relationship of prolonged atrial mechanical delay with non-dipper prehypertension, 12 obesity, 13 mitral annulus calcification, 14 and connective tissue diseases. [23][24][25] Deniz et al 26 demonstrated that intra-left atrial mechanical delay was an independent risk factor for PAF when the cut-off point was 25 ms, with a sensitivity of 79% and a specificity of 66%. 22 In addition, previous studies have shown that patients with AF exhibited increased atrial mechanical delay, especially in patients with AF recurrence.…”

Section: Association Between Atrial Mechanical Delay and Cardiac DImentioning

confidence: 99%

“…22 In addition, previous studies have shown that patients with AF exhibited increased atrial mechanical delay, especially in patients with AF recurrence. [23][24][25] Deniz et al 26 demonstrated that intra-left atrial mechanical delay was an independent risk factor for PAF when the cut-off point was 25 ms, with a sensitivity of 79% and a specificity of 66%.…”

Section: Association Between Atrial Mechanical Delay and Cardiac DImentioning

confidence: 99%

The predictive value of intra‐left atrial mechanical delay for 1‐year recurrence of atrial fibrillation after catheter ablation: A clinical follow‐up study using dual Doppler echocardiography

Zhou

Chen

et al. 2018

J of Clinical Ultrasound

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“…P wave analysis using standard surface 12-lead electrocardiography (ECG) is a simple and cost-effective modality for determining the prognosis of AF. We recently reported that low P wave amplitude in lead I with displaced interatrial conduction, 7 and prolonged PR interval, 8 are associated with a higher clinical recurrence rate of AF after catheter ablation.…”

Section: Introductionmentioning

confidence: 98%

Prognostic Value of Inferior Shift of P wave Axis after Catheter Ablation for Longstanding Persistent Atrial Fibrillation based on Dallas Lesion Set Including Anterior Line

et al. 2017

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Background and Objectives: Although an anterior linear ablation is an effective lesion set in radiofrequency catheter ablation (RFCA) for longstanding persistent atrial fibrillation (L-PeAF), its durability for bidirectional block (BDB) is only about 60% at repeat procedure. We hypothesized that changes in electrocardiogram (ECG) may predict an anterior line block state and the clinical outcome of L-PeAF ablation. Subjects and Methods: We studied 304 L-PeAF patients (77% male, 60±10yrs), who consistently underwent RFCA Dallas lesion set (circumferential pulmonary vein isolation, posterior box lesion, and anterior line) protocol with subsequent comparison of pre-procedural and post-procedural P wave axes, and one year follow-up (n=205) sinus rhythm (SR) ECGs. Results: 1. P wave axis shifted inferiorly at immediate post-procedure (p<0.001), and was independently correlated with BDB of anterior line (ß=10.4, 95% confidence interval [CI] 2.79-17.94, p=0.008). 2. The degree of post-procedural inferior shift of P wave axis did not reflect clinical recurrence within one-year (n=205, p=0.923), potentially due to conduction recovery of an anterior line. However, among 160 patients without clinical recurrence within one-year, P wave axis at one-year ECG was independently associated with very late recurrence of AF after one-year (n=160, hazard ratio [HR] 0.98; 95% CI 0.97-0.99, p=0.001), during 45.6±16.7 months of follow-up. 3. Among 22 patients who underwent repeat procedures, P wave axis shift was more significant in patients with maintained BDB of an anterior line than in those without (p=0.015). Conclusion: An inferior shift of P wave axis reflects the achievement and the maintenance of an anterior line BDB, and is associated with better long-term clinical outcome after catheter ablation for L-PeAF based on Dallas lesion set.

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Prolonged PR Interval Predicts Clinical Recurrence of Atrial Fibrillation After Catheter Ablation

Cited by 51 publications

References 38 publications

Genomic Contributors to Rhythm Outcome of Atrial Fibrillation Catheter Ablation – Pathway Enrichment Analysis of GWAS Data

Genomic Contributors to Rhythm Outcome of Atrial Fibrillation Catheter Ablation – Pathway Enrichment Analysis of GWAS Data

The predictive value of intra‐left atrial mechanical delay for 1‐year recurrence of atrial fibrillation after catheter ablation: A clinical follow‐up study using dual Doppler echocardiography

Prognostic Value of Inferior Shift of P wave Axis after Catheter Ablation for Longstanding Persistent Atrial Fibrillation based on Dallas Lesion Set Including Anterior Line

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