P wave duration as a predictor of AF recurrence
Research type
Research Study
Full title
Exploring the relationship between duration of the Amplified P-Wave arrhythmia and recurrence in patients with persistent, long persistent or paroxysmal AF undergoing cryoablation.
IRAS ID
287263
Contact name
Guy Haywood
Contact email
Sponsor organisation
University Hospital Plymouth NHS Trust
Duration of Study in the UK
0 years, 6 months, 0 days
Research summary
Atrial fibrillation (AF) is an abnormal rhythm causing the heart to beat irregularly. In some cases, where medical therapy is not effective or tolerated doctors invite patients to undergo a potentially curative procedure called ablation. Doctors use special catheters via a keyhole operation to reach inside the heart and apply freezing temperatures in the areas that are most commonly responsible to cause the abnormal rhythm. One of the most commonly used techniques is via a balloon to apply local cold areas, although for other patients a local thermal effect can be used by different catheters. Several studies have identified the success rates of this technique to be around 75% for patients with intermittent AF with the success rates being lower (50%) for patients with more established disease.
We would like to understand if by studying some baseline parameters (p wave duration), on a surface electric documentation of the tracing of the heart (ECG) when the heart beats regularly, we can predict patient’s response to a successful procedure. By measuring this, we will try to evaluate if we can predict failure of the procedure in patients with a prolonged parameter.
Patients with persistent (AF > 7 days) and long persistent atrial fibrillation (AF > 1 year) exhibit low rates of successful AF ablation. This can be explained, at least in part, by the continuous atrial remodelling that takes place in the left atrium, augmenting the number of AF drivers away from the traditional pulmonary veins site for ablation.Clinical biomarkers that can predict which type of AF is resistant to catheter ablation are not very well understood. P wave duration(PWD) on a 12-lead ECG has been shown to be a simple and potential way to predict recurrent post-ablation outcomes in simple pulmonary vein isolation (PVI), recurrence of AF after cardioversion and recurrence of AF after atrial flutter ablation.We aim to assess whether PWD can be used to predict recurrence of AF in a population of persistent, long persistent and paroxysmal AF (AF sustained episodes less than 48 hours) that undergo AF cryoablation.REC name
London - Surrey Borders Research Ethics Committee
REC reference
21/PR/0437
Date of REC Opinion
9 Apr 2021
REC opinion
Favourable Opinion