Atrial myxoma surgery and P-wave remodeling

Area of Science:

• Cardiology
• Electrophysiology
• Cardiac Surgery

Background:

• Atrial myxomas, the most common primary cardiac tumors, can cause various clinical manifestations.
• Electrocardiographic (ECG) data in atrial myxoma patients, especially concerning atrial parameters, are limited.
• Understanding these ECG changes can aid in diagnosis and risk stratification.

Purpose of the Study:

• To investigate atrial electrocardiographic features in patients diagnosed with atrial myxoma before and after surgical resection.
• To analyze the incidence of atrial fibrillation (AF) during long-term follow-up.
• To determine the correlation between P-wave indices and AF occurrence.

Main Methods:

• A cohort of 32 patients in sinus rhythm undergoing atrial myxoma surgery was studied.
• Atrial ECG parameters were assessed pre-operatively and post-operatively.
• Follow-up data, including AF episodes, were collected over a mean period of 10 years.

Main Results:

• Significant improvements in P-wave duration, partial interatrial block (IAB), and P-wave terminal force in lead V1 were observed post-surgery.
• Pre-operative partial IAB was present in 21.9% of patients.
• At follow-up, 31.3% of patients experienced at least one episode of AF, with post-operative P-wave duration being a significant predictor (HR: 0.90, p=0.020).

Conclusions:

• Atrial electrocardiographic abnormalities are prevalent in atrial myxoma patients and often resolve or improve after surgical removal.
• Post-operative P-wave duration serves as a valuable indicator for predicting the likelihood of developing atrial fibrillation during long-term follow-up.