Usefulness of Morphology-Voltage-P-wave duration (MVP) score as a predictor of atrial fibrillation recurrence after pulmonary vein isolation

Ann Noninvasive Electrocardiol. 2020 Nov;25(6):e12773. doi: 10.1111/anec.12773. Epub 2020 Jun 21.

Abstract

Background: Atrial fibrillation (AF) is known to be the most common arrhythmia, and the successful rate of long-term ablation can vary comparatively. Therefore, a clinical scoring system to predict rhythm outcome remains a critical unmet need. The electrocardiographic (ECG) risk score which is named Morphology-Voltage-P-wave duration (MVP) score was reported to be useful for predicting new-onset AF. The goal of the current study was to investigate whether the MVP score was a useful scheme in the prediction of rhythm outcome following pulmonary vein isolation (PVI) in paroxysmal atrial fibrillation (PAF).

Methods: We retrospectively analyzed baseline characteristics, risk scores, and rates of AF recurrence 12 months postablation in the medical records of 207 consecutive patients with PAF undergoing PVI in General Hospital of Ningxia medical University from 2010 to 2018.

Results: Two hundred and seven patients (71 females, median age 58.7 years) with symptomatic PAF underwent PVI. From the cohort, 32.3% (67) had a recurrence of AF within 1 year of the PVI. The area of the MVP score under the curve in the receiver operating characteristics (ROC) analysis was 0.789 (95% CI 0.730-0.840, p < .001). A score cut-off value of >3 showed the best predictive ability for AF recurrence within 1 year after PVI, with sensitivity (53.03%) and specificity (89.87%).

Conclusions: The results of our study suggest that the easy-to-measure ECG MVP score can be used to predict recurrence of PAF after PVI.

Keywords: MVP score; atrial fibrillation; paroxysmal atrial fibrillation; percutaneous radiofrequency ablation; predictor; pulmonary vein isolation.

MeSH terms

  • Aged
  • Atrial Fibrillation / diagnosis*
  • Atrial Fibrillation / physiopathology*
  • Catheter Ablation / methods*
  • Electrocardiography / methods*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Pulmonary Veins / physiopathology*
  • Pulmonary Veins / surgery*
  • Recurrence
  • Retrospective Studies
  • Time
  • Treatment Outcome