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Prolonged PR Interval Predicts Clinical Recurrence of Atrial Fibrillation After Catheter Ablation

Authors
 Junbeom Park  ;  Tae‐Hoon Kim  ;  Jihei Sara Lee  ;  Jin Kyu Park  ;  Jae Sun Uhm  ;  Boyoung Joung  ;  Moon Hyoung Lee  ;  Hui‐Nam Pak 
Citation
 JOURNAL OF THE AMERICAN HEART ASSOCIATION, Vol.3(5) : 001277, 2014 
Journal Title
 JOURNAL OF THE AMERICAN HEART ASSOCIATION 
Issue Date
2014
MeSH
Aged ; Anti-Arrhythmia Agents/therapeutic use ; Atrial Fibrillation/diagnosis* ; Atrial Fibrillation/mortality ; Atrial Fibrillation/surgery* ; Atrial Remodeling/physiology* ; Body Surface Potential Mapping/methods* ; Catheter Ablation/adverse effects ; Catheter Ablation/methods* ; Cohort Studies ; Female ; Humans ; Imaging, Three-Dimensional* ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Predictive Value of Tests ; Proportional Hazards Models ; Prospective Studies ; Recurrence ; Risk Assessment ; Severity of Illness Index ; Time Factors ; Treatment Outcome
Keywords
PR interval ; atrial fibrillation ; catheter ablation ; recurrence ; remodeling
Abstract
BACKGROUND: A prolonged PR interval is known to be a poor prognostic factor in cardiovascular disease. The aim of this study was to investigate the association between PR interval and clinical outcome in patients undergoing radiofrequency catheter ablation (RFCA) of atrial fibrillation (AF). METHODS AND RESULTS: We prospectively included 576 patients with AF (75.5% male, 57.8±11.6 years old, 68.8% paroxysmal AF) who underwent RFCA. We analyzed preprocedural sinus rhythm ECGs obtained in the absence of antiarrhythmic drug, and all enrolled patients were categorized into 4 groups based on the quartile values of the PR interval (166, 182, and 202 ms), and were analyzed according to the left atrium (LA) volume (CT; Computed tomography), LA voltage (NavX), and clinical outcome of AF ablation. Based on quartile value of PR interval, the highest quartile of PR interval (Q4; PR ≥202 ms) was oldest (P<0.001), and most likely to have persistent AF (P<0.001) and hypertension (P=0.013) compared with the other groups. However, there was no significant difference in LA conduction velocity and atrial effective refractory period. Q4 had the greatest LA dimension (P<0.001) and volume index (P<0.001), and lowest LA appendage-emptying velocity (P<0.032) and LA voltage (P<0.001) compared with the others. For 13.1±7.5 months, the classification based on the PR interval was a significant predictor of AF recurrence after RFCA of AF (HR=1.969, 95% CI 1.343 to 2.886, P=0.001). CONCLUSIONS: The PR interval was closely associated with advanced LA remodeling due to AF, and had a noninvasive significant predictive value of clinical recurrence of AF after RFCA.
Files in This Item:
T201403825.pdf Download
DOI
10.1161/JAHA.114.001277
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Park, Jun Beom(박준범)
Park, Jin Kyu(박진규)
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Lee, Moon Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/100241
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