INDICES FROM ECG, P WAVE-SAECG AND TISSUE DOPPLER IMAGING MAY BE PROGNOSTIC OF FUTURERELAPSES IN PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION.
Authors: Polychronis Dilaveris, Petros Arsenos, Dimitros Mytas, Ioannis Tsiantis, Konstantinos Papadopoulos, Konstantinos Gatzoulis, Anna Kefala, Sofia Vaina, Anastasia Kitsiou, Christodoulos Stefanadis
Purpose: Patients with paroxysmal atrial fibrillation (PAF) may show arrhythmia recurrences. Research of PAF substrate is of major clinical importance.
Methods: 50 patients (mean age 65±15.4 years, 24 male) after the cardioversion of a documented PAF episode (and #5 PAF episodes for the last 3 years)evaluated with 12 lead ECG, P-wave Signal- Averaged ECG, 30 min High-Resolution Holter and Echocardiographic study (2D,PWD,TDI). After 2 years of follow-up, patients were classified into those who showed PAF relapse (PAFR, n=10 pts) and those who remained in sinus rhythm (SR=40pts).
Results: The two groups did not differ in the autonomic nervous system status, left and right ventricular systolic function and left and right atrial volume indices. In contrast, diastolic function was found significantly affected for both left and right chambers. P Index from ECG (the SD of P wave duration across all leads from ECG) and RMS30 from PSAECG were found statistically importantly increased in PAFR group (Table 23.1.).
Conclusions: Substrate of combined early affected diastolic myocardial tissue properties and impaired electrical status were found in patients with new PAF episodes and frequent relapses.