Prolonged P-wave duration is associated with atrial fibrillation recurrence after radiofrequency catheter ablation: A systematic review and meta-analysis

Abstract

Background/objectives: A change in the P-wave duration (PWD) was made in patients with atrial fibrillation recurrence (AFR) after radiofrequency catheter ablation (RFCA). The correlation between the PWD and AFR and the potential utilization of a prolonged PWD in the prediction of AFR after RFCA remains unclear.

Methods: Studies of PWD in patients with or without AFR after RFCA, and studies concerned with the predictive effect of prolonged PWD on AFR after RFCA, were included. Outcome measures are reported as absolute risk differences with 95% confidence intervals. A receiver operating characteristic (ROC) curve was used to evaluate the potential cutoff value of PWD for AFR. Summary receiver operating characteristic curve (SROC) analysis was performed to show the overall predictive value of PWD for AFR.

Results: Nine studies were included. The overall effect test based on 8 studies that contained a total cohort of 1010 patients showed a highly significant association between prolonged PWD and AFR after RFCA (Z=14.20, P<0.000). A summary that included 4 studies with a combined total of 593 patients indicated a higher risk of AFR in patients with prolonged PWD (Z=5.86, P<0.000). ROC curve analysis indicated 149.5ms as the potential cutoff value of PWD for AFR after RFCA. SROC analysis suggested an acceptable predictive efficiency of PWD for AFR (AUC=0.66).

Conclusions: The risk of AFR after RFCA is strongly related to a prolonged PWD. PWD is one potential low-cost and feasible predictor of AFR after RFCA.

Keywords: Atrial fibrillation; Atrial fibrillation recurrence; Meta-analysis; P-wave duration; Radiofrequency catheter ablation.