Predicting outcomes in persistent atrial fibrillation: the impact of surface ECG f-wave amplitude following pulmonary vein isolation

• DOI: 10.1007/s10840-025-02018-7
• Publication Date: 2025-02-19T10:48:22Z
• Authors: Aruran Baskaralingam; Matteo Marchetti; Jorge Solana-Munoz; Cheryl Teres; Mathieu Le Bloa; Alessandra Pia Po...; Giulia Domenichini; Ciro Ascione; Laurent Roten; Sven Knecht; Michael Kühne; Christian Sticher...; Patrizio Pascale; Etienne Pruvot; Adrian Luca

Fibrillatory wave amplitude (fWA) on 12-lead ECG predicts the outcome of ablation in atrial fibrillation (AF). We hypothesized that changes fWA following wide circumferential isolation pulmonary veins (WPVI) persistent AF (peAF) is a better predictor compared to baseline fWA. Eighty-nine patients (sustained peAF 7 ± months) underwent first-time WPVI. Sixty-second signals devoid QRST waves were recorded at and end WPVI (endWPVI). for each lead mean (meanfWA) across computed. Patients with recurrence after index redo ensure complete PVI. The primary endpoint was long-term freedom OFF antiarrhythmics drugs (AADs) one or two (SUCCESS group). FAILURE group defined as post-redo. Over follow-up 35 10 months, from AADs achieved 61% group), while 29% had (FAILURE SUCCESS showed significantly higher values leads V1, V4, V5 (p < 0.05), well III, aVL, aVF, meanfWA endWPVI 0.05) group. A ≥ 0.044 mV decrease ≤ 11% predicted sinus rhythm restoration sensitivity 81% specificity 69% 0.05). Low significant reduction are associated high risk peAF.