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Depolarization and repolarization parameters on ECG predict recurrence after atrial fibrillation ablation in patients

Song-Nan Wen1, Hao-Jie Zhu1, Peng-Yu Sun1

  • 1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Journal of Cardiovascular Electrophysiology
|August 24, 2019
PubMed

Insights

QTc prolongation and fragmented QRS (fQRS) predict atrial fibrillation (AF) ablation failure in hypertrophic cardiomyopathy (HCM) patients. Combining these markers improves risk prediction for AF recurrence after ablation.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Diagnostics

Background:

  • Atrial fibrillation (AF) ablation outcomes are suboptimal, particularly in patients with structural heart disease like hypertrophic cardiomyopathy (HCM).
  • Identifying patients likely to benefit from AF ablation or experience treatment failure is crucial for personalized management.

Purpose of the Study:

  • To investigate preprocedural QTc interval and fragmented QRS (fQRS) as predictors of AF recurrence after ablation in HCM patients.
  • To evaluate the combined predictive value of QTc prolongation and fQRS for AF recurrence in this population.

Main Methods:

  • 120 HCM patients undergoing primary AF ablation were enrolled.
  • Preprocedural QTc interval and fQRS presence were assessed.
  • Arrhythmia recurrence was monitored over a median follow-up period.

Main Results:

  • Arrhythmia recurrence was observed in 69 patients (57.5%) after 13.4 months.
  • fQRS was present in 59.17% of patients, predominantly in inferior leads.
  • QTc > 448 ms (HR: 1.982) and fQRS+ (HR: 1.922) were independent risk factors for recurrence.
  • The combination of fQRS+ and QTc > 448 ms showed superior predictive value for recurrence.

Conclusions:

  • QTc prolongation (>448 ms) and fQRS are independent risk factors for AF recurrence post-ablation in HCM patients.
  • The combination of fQRS and prolonged QTc offers enhanced predictive value for procedural failure.
  • These findings can aid in identifying high-risk HCM patients for AF ablation.
Abstract

Keywords:
QTc intervalatrial fibrillationcatheter ablationfragmented QRShypertrophic cardiomyopathy

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