Atrial late potentials are associated with atrial fibrillation recurrence after catheter ablation

Previous studies have identified noninvasive methods for predicting atrial fibrillation (AF) recurrence after catheter ablation (CA). We assessed the association between AF recurrence and atrial late potentials (ALPs), which were measured using P-wave signal-averaged electrocardiography (P-SAECG).

Consecutive patients with paroxysmal AF who underwent their first CA at our institution between August 2015 and August 2019 were enrolled. P-SAECG was performed before CA. Two ALP parameters were evaluated: the root-mean-square voltage during the terminal 20 ms (RMS₂₀) and the P-wave duration (PWD). Positive ALPs were defined as an RMS₂₀ <2.2 μV and/or a PWD >115 ms. Patients were allocated to either the recurrence or nonrecurrence group based on the presence of AF recurrence at the 1-year follow-up post-CA.

Of the 190 patients (age: 65 ± 11 years, 37% women) enrolled in this study, 21 (11%) had AF recurrence. The positive ALP rate was significantly higher in the recurrence group than in the nonrecurrence group (86% vs. 64%, p = .04), despite the absence of differences in other baseline characteristics between the two groups. In the multivariate analysis, positive ALP was an independent predictor of AF recurrence (odds ratio: 3.83, 95% confidence interval: 1.05-14.1, p = .04).

Positive ALP on pre-CA P-SAECG is associated with AF recurrence after CA.