Abstract

Background

Left atrial scar is an important entity in the atrial fibrillation substrate. P wave dispersion (PWD) is an indicator of slow and inhomogeneous conduction in the atria. In this study, we aim to investigate the relation between PWD and left atrial scars identified by electroanatomical mapping.

Methods

Patients who had an electroanatomical map obtained during sinus rhythm as well as at least one electrocardiogram in sinus rhythm prior to the procedure were included in the study. Left atrial scar (defined as <0.5 mV) area was calculated on the electroanatomical map. Maximum and minimum P wave duration and PWD were compared between patients with and without left atrial scar.

Results

A total of 224 patients were enrolled in the study. Of them, 47.9% of the patients were female. On the electroanatomical map, left atrial scar was identified in 103 patients, and no scar was present in 121 patients. PWD was significantly increased in patients with left atrial scar when compared to the no-scar group (46 ms ± 20 vs. 38 ms ± 15, respectively, p < 0.001). Similarly, PWD was significantly increased in patients with moderate-to-severe scar, when compared to patients with mild scar (50 ms ± 19 vs. 41 ms ± 19, respectively, p = 0.026). PWD was found not to be a good predictor of left atrial scar with an AUC of 0.625 for scar vs. no scar.

Conclusion

PWD is significantly increased in patients with left atrial scar identified by electroanatomical mapping, however, the receiver operating characteristic analysis showed that PWD is not a good predictor of presence of left atrial scar.

中文翻译：

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房颤导管消融患者左房瘢痕与P波离散度的关系

摘要

背景

左心房瘢痕是房颤基质中的一个重要实体。P 波离散度 (PWD) 是心房中缓慢且不均匀传导的指标。在本研究中，我们旨在研究 PWD 与通过电解剖标测确定的左心房瘢痕之间的关系。

方法

该研究包括在手术前获得窦性心律期间获得的电解剖图以及至少一份窦性心律心电图的患者。在电解剖图上计算左心房瘢痕（定义为<0.5 mV）面积。比较有和没有左心房瘢痕患者的最大和最小 P 波持续时间和 PWD。

结果

共有 224 名患者参加了该研究。其中，47.9%的患者为女性。在电解剖图上，103 名患者发现左心房疤痕，121 名患者无疤痕。与无疤痕组相比，左心房疤痕患者的 PWD 显着增加（分别为 46 ms ± 20 和 38 ms ± 15，p  < 0.001）。同样，与轻度疤痕患者相比，中度至重度疤痕患者的 PWD 显着增加（分别为 50 ms ± 19 和 41 ms ± 19，p  = 0.026）。发现 PWD 不是左心房瘢痕的良好预测指标，瘢痕与无瘢痕的 AUC 为 0.625。

结论

通过电解剖标测确定的左心房瘢痕患者的 PWD 显着增加，然而，接受者操作特征分析表明 PWD 不是左心房瘢痕存在的良好预测因子。