Value of P-wave dispersion, NT-proBNP for prediction of recurrence of atrial fibrillation following cryoballoon ablation

doi:10.16150/j.1671-2870.2020.01.008

Abstract

Abstract:

Objective: To investigate the predictive value of P-wave dispersion and N-terminal pro-brain natriuretic peptide (NT-proBNP) for recurrence of atrial fibrillation (AF) after successful cryoballoon ablation. Methods: A total of 182 patients with paroxysmal AF with successful cryoballoon ablation were enrolled. A 12-lead electrocardiogram (EKG) was used to record the P-wave for calculating P-wave dispersion before ablation and 1 day, 1 month, 3 months and 6 months after ablation, and plasma NT-proBNP was measured at the same time. A 6-month follow-up was carried out for studying the recurrence of AF, and the clinical, EKG and ablation data were analyzed. Results: The recurrence rate of AF within 6 months after successful cryoballoon ablation was 21.4%. Compared with patients with AF recurrence, those without AF recurrence were younger in age [(47.6±6.1) years vs. (60.2±9.5) years], having higher percentage of lone AF（69.5% vs. 47.3%） and smaller P-wave dispersion. P-wave dispersions were decreased at 3, 6 months after ablation in patients without AF recurrence, while in patients with AF recurrence no significant changes were found. Level of NT-proBNP in patients without AF recurrence were lower than those in patients with AF recurrence. Level of NT-proBNP was decreased after ablation in patients without AF recurrence, while no significant change was found in patients with AF recurrence. Meanwhile patients remained free from AF for 6 months had smaller left atrial diameter(LAD) before ablation than those with recurrence of AF[（41.3±2.7） mm vs.( 46.6±4.4) mm], and LAD was further decreased at 6 months [from(41.3±2.7) mm to (38.0±2.0) mm] (P<0.05). Multivariate regression analysis showed that LAD (OR: 1.3, 95% CI: 0.9-1.0, P<0.05), P-wave dispersion (OR: 1.2, 95% CI: 1.0-1.1, P=0.04） and NT-proBNP level(OR: 2.3, 95%CI: 1.3-1.7, P=0.03) before ablation were independent predictors of AF recurrence after ablation. Conclusions: P-wave dispersion and NT-proBNP level may provide reference information for prediction of recurrence of AF after cryoballon ablation.

Key words: P-wave dispersion, NT-proBNP, Atrial fibrillation, Cyroballoon ablation, Recurrence

CLC Number:

R541.75

LUO Xiaoying, XU Yan, ZHANG Fengru, WU Liqun, QI Wenhang. Value of P-wave dispersion, NT-proBNP for prediction of recurrence of atrial fibrillation following cryoballoon ablation[J]. Journal of Diagnostics Concepts & Practice, 2020, 19(1): 32-36.

Figures/Tables 4

References 10

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参数	房颤复发组（n=39）	无房颤复发组（n=143）
年龄（岁）	60.2±9.5^a)	47.6±6.1
男性（%）	48.7	43.4
孤立性房颤（%）	47.3^a)	69.5
房颤史（月）	40.2±27.6	31.3±22.7
体质量指数（kg/m²）	30.4±4.9	28.9±4.1
血肌酐（μmol/L）	83.3±22.6	87.1±19.0
肾小球滤过率[mL/(min·1.73 m²)]	78.3±7.1	80.5±6.4
他汀使用率（%）	27.0	29.3
ACEI和（或）ARB使用率（%）	39.7	44.9
X线曝光时间（min）	15.9±1.7	12.7±1.5

时间点	房颤复发组（n=39）	无房颤复发组（n=143）
术前	75.7±16.4^a)	61.6±18.5
术后1 d	73.4±16.2^a)	60.1±14.5
术后1个月	69.8±15.0^a)	58.4±12.9
术后3个月	68.1±15.8^a)	42.7±9.4^b)
术后6个月	68.2±14.9^a)	39.9±8.8^b)

时间点	房颤复发组（n=39）	无房颤复发组（n=143）
术前	413.6±105.8^a)	157.1±68.4
术后1天	417.5±124.9^a)	178.6±72.2
术后1个月	425.3±97.4^a)	87.3±47.6^b)
术后3个月	404.9 ±96.1^a)	62.5±40.9^b)
术后6个月	391.4 ±88.6^a)	51.5±34.3^b)

参数	房颤复发组（n=39）		无房颤复发组(n=143)
参数	术前	术后6个月	术前	术后个6月
LAD (mm)	46.6±4.4^a)	45.8±4.2^a)	41.3±2.7	38.0±2.0^b)
LVEF（%）	59.4±8.6	58.1±8.7	55.5±8.7	56.6±7.9
E/A	1.1±0.5	1.2±0.4	1.0±0.4	1.2±0.6
E/e'	9.6±3.2	10.1±3.8	10.0±3.7	10.3±4.1