Journal of Diagnostics Concepts & Practice >

2020 , Vol. 19 >Issue 1: 32 - 36

DOI: https://doi.org/10.16150/j.1671-2870.2020.01.008

Original articles

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

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  • Department of Cardiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China

Received date: 2019-07-16

  Online published: 2020-02-25

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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

Cite this article

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 . DOI: 10.16150/j.1671-2870.2020.01.008

References

[1] Ha AC, Wijeysundera HC, Birnie DH, et al. Real-world outcomes, complications, and cost of catheter-based ablation for atrial fibrillation: an update[J]. Curr Opin Cardiol, 2017, 32(1):47-52.
[2] Aagaard P, Briceno D, Csanadi Z, et al. Atrial fibrillation ablation and stroke[J]. Cardiol Clin, 2016, 34(2):307-316.
[3] Boveda S. Cryoballoon ablation in atrial fibrillation: Advantages and drawbacks[J]. Rev Port Cardiol, 2017, 36(Suppl 1):19-24.
[4] Carballo D, Noble S, Carballo S, et al. Biomarkers and arrhythmia recurrence following radiofrequency ablation of atrial fibrillation[J]. J Int Med Res, 2018, 46(12):5183-5194.
[5] Arana-Rueda E, Pedrote A, García-Riesco L, et al. Clinical value of N-terminal pro-B-type natriuretic peptide measurement in the follow up of pulmonary vein ablation[J]. Med Clin (Barc), 2015, 145(6):248-250.
[6] Giannopoulos G, Kossyvakis C, Angelidis C, et al. Amino-terminal B-natriuretic peptide levels and postablation recurrence in hypertensive patients with paroxysmal atrial fibrillation[J]. Heart Rhythm, 2015, 12(7):1470-1475.
[7] Leonelli FM, Locati ET, Bagliani G, et al. P wave analysis in the era of atrial fibrillation ablation[J]. Card Electrophysiol Clin, 2018, 10(2):299-316.
[8] Chávez-González E, Donoiu I. Utility of P-wave dispersion in the prediction of atrial fibrillation[J]. Curr Health Sci J, 2017, 43(1):5-11.
[9] Mugnai G, Chierchia GB, de Asmundis C, et al. P-wave indices as predictors of atrial fibrillation recurrence after pulmonary vein isolation in normal left atrial size[J]. J Cardiovasc Med (Hagerstown), 2016, 17(3):194-200.
[10] Aytemir K, Amasyali B, Kose S, et al. Maximum P-wave duration and P-wave dispersion predict recurrence of paroxysmal atrial fibrillation in patients with Wolff-Parkinson-White syndrome after successful radiofrequency catheter ablation[J]. J Interv Card Electrophysiol, 2004, 11(1):21-27.
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