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Clinical value of fibrillatory wave amplitude on surface ECG in patients with persistent atrial fibrillation

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Abstract

Purpose

We postulated that amplitude of fibrillatory (F)-wave in patients with persistent AF would correlate with clinical characteristics and outcome in patients undergoing catheter ablation for AF.

Method

Maximal and mean amplitude of F-waves were measured in V1 and lead II in 90 patients prior to ablation for persistent AF. F-wave amplitudes were correlated to clinical, echocardiographic variables, and outcome.

Results

F-wave ≥ 0.1 mV in lead II and V1was correlated with younger age and shorter AF history, and in lead II only was correlated with a smaller left atrium. Higher F-wave amplitude at baseline predicted AF termination during ablation. Maximal amplitude of ≥ 0.07 mV predicted AF termination by ablation with 82%/79% sensitivity and 68%/73% specificity in V1/lead II respectively. An association between F-wave amplitude and AF recurrence was observed. Forty-three percent of patients with mean f wave amplitude <0.05 in lead V1 had AF recurrence compared to 12% of those with F-wave ≥ 0.05 (p = 0.004).

Conclusion

Longer AF duration, older age and larger LA size are associated with fine AF amplitude. High F-wave amplitude predicts procedural termination of arrhyhmia in patients with persistent AF and freedom from AF upon follow-up.

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Abbreviations

AF:

Atrial Fibrillation

AT:

Atrial Tachycardia

DF:

Dominant Frequency

F-wave:

Fibrillatory wave

LA:

Left atrium

LAA:

Left atrial appendage

LV:

Left ventricle

LVEF:

Left ventricular ejection fraction

ROC:

Receiver operator correlations

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Disclosures

Sébastien Knecht is supported by the Belgian Foundation for Cardiac Surgery.

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Authors and Affiliations

  1. Hôpital Cardiologique Haut-Lévêque, Bordeaux-Pessac, Université Victor Segalen Bordeaux 2, Bordeaux, France

    Isabelle Nault, Nicolas Lellouche, Seiichiro Matsuo, Sébastien Knecht, Matthew Wright, Kang-Teng Lim, Frederic Sacher, Antoine Deplagne, Pierre Bordachar, Nicolas Derval, Mark D. O’Neill, Mélèze Hocini, Pierre Jaïs, Jacques Clémenty & Michel Haïssaguerre

  2. Lund University, Lund, Sweden

    Pyotr Platonov

  3. University of Western Ontario, London, ON, Canada

    George J Klein

  4. Hôpital Cardiologique Haut-Lévêque, Avenue de Magellan, 33 604, Bordeaux-Pessac cedex, France

    Isabelle Nault

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  1. Isabelle Nault
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  2. Nicolas Lellouche
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  7. Frederic Sacher
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  9. Antoine Deplagne
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  10. Pierre Bordachar
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  11. Nicolas Derval
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  12. Mark D. O’Neill
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  13. George J Klein
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  14. Mélèze Hocini
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  15. Pierre Jaïs
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  16. Jacques Clémenty
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  17. Michel Haïssaguerre
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Correspondence to Isabelle Nault.

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Nault, I., Lellouche, N., Matsuo, S. et al. Clinical value of fibrillatory wave amplitude on surface ECG in patients with persistent atrial fibrillation. J Interv Card Electrophysiol 26, 11–19 (2009). https://doi.org/10.1007/s10840-009-9398-3

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  • DOI: https://doi.org/10.1007/s10840-009-9398-3

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