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Use of P wave indices to evaluate efficacy of catheter ablation and atrial fibrillation recurrence: a systematic review and meta-analysis

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Abstract

Background

To investigate the changes of P wave indices in atrial fibrillation (AF) patients after catheter ablation and the association between P wave indices and AF recurrence.

Methods

PubMed, Embase, and Cochrane Database were searched through September 15th 2021 for studies on the association between P wave indices and AF with catheter ablation. Heterogeneity was estimated using the I2 statistic, the random effects model was used to calculate the pooled results, and summary receiver operating characteristic curve (SROC) was used to evaluate the predictive value.

Results

Among included fourteen studies with 1674 AF patients, we found significantly decreased P wave dispersion (Pdis) (mean difference [MD]: − 6.5 ms, 95% confidence interval [95% CI]: − 11.81 to − 1.18, P = 0.02) after cryoballoon ablation (CBA) or radiofrequency ablation (RFA), and maximum P wave (Pmax) (MD: − 8.57 ms, 95% CI: − 17.03 to − 0.10, P = 0.05) after RFA only, but increased minimum P wave (Pmin) (MD: 3.43 ms, 95% CI: 1.07 to 5.79, P < 0.01) after CBA only. Pdis measured before ablation was remarkably higher (MD: 5.79 ms, 95% CI: 2.23 to 9.36, P < 0.01) in patients with recurrence than without; meanwhile, Pmax was higher measured both before and after ablation (MD: 6.49 ms, 95% CI: 2.30 to 10.69, P < 0.01 and MD: 11.2 ms, 95% CI: 2.88 to 19.52, P < 0.01). Furthermore, SROC analysis showed acceptable predictive efficiencies of Pdis (AUC = 0.776) and Pmax (AUC = 0.759) for AF recurrence.

Conclusion

Pdis was significantly decreased after AF catheter ablation. Higher Pdis and Pmax may have predictive values for AF recurrence.

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Data availability

All data generated or analyzed during this study are included in this article.

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Funding

This work was supported by Beijing Municipal Administration of Hospitals’ Ascent Plan (DFL20190902) of Professor Ping Zhang.

Beijing Municipal Administration of Hospitals’ Ascent Plan,DFL20190902,Ping Zhang

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Author notes

  1. Peng Liu and Tingting Lv contributed equally to this work as co-first authors.

Authors and Affiliations

  1. School of Clinical Medicine, Tsinghua University, Beijing, 100084, China

    Peng Liu, Ying Yang, Qinggele Gao & Ping Zhang

  2. Department of Cardiology, School of Clinical Medicine, Beijing Tsinghua Changgung Hospital, Tsinghua University, No. 168 Litang Road, Changping District, Beijing, 102218, China

    Tingting Lv & Ping Zhang

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  1. Peng Liu
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Correspondence to Ping Zhang.

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Liu, P., Lv, T., Yang, Y. et al. Use of P wave indices to evaluate efficacy of catheter ablation and atrial fibrillation recurrence: a systematic review and meta-analysis. J Interv Card Electrophysiol 65, 827–840 (2022). https://doi.org/10.1007/s10840-022-01147-7

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  • DOI: https://doi.org/10.1007/s10840-022-01147-7

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