The Efficacy of ECG P-Wave Dispersion Combined with QTc Interval in Predicting Early Recurrence After Radiofrequency Ablation for Paroxysmal Atrial Fibrillation
Objective:To investigate the efficacy of electrocardiogram(ECG)P-wave dispersion(Pd)combined with QTc interval in predicting early recurrence after radiofrequency ablation(RFA)for paroxysmal atrial fibrillation(PAF).Methods:A total of 108 PAF patients who underwent RFA from January 2019 to June 2023 were selected and followed up for 3 months after the operation.They were divided into a recurrence group(28 cases)and a non-recurrence group(80 cases)based on recurrence status.Baseline data,preop-erative and postoperative 7-day Pd,QTc,and the differences(△Pd,△QTc)between preoperative and post-operative 7-day Pd,QTc were compared between the two groups.The influence of Pd and QTc on early post-operative recurrence and their predictive efficacy were analyzed.Results:The disease course was longer,and the proportion of hypertension and CHA2DS2-VASc scores were higher in the recurrence group compared to the non-recurrence group(P<0.05).Preoperative and postoperative 7-day Pd(32.68±5.75)ms,(26.27±7.13)ms were higher than those in the non-recurrence group(28.51±5.04)ms,(17.16±6.28)ms,and QTc(458.27±52.31)ms,(410.65±30.52)ms were longer than those in the non-recurrence group(430.19±39.62)ms,(372.06±25.40)ms(t=3.631,6.376,2.960,6.558,all P<0.001).Preoperative and postoperative 7-day △Pd(6.41±2.67)ms,△QTc(47.62±10.33)ms were lower in the recurrence group than in the non-recurrence group(11.35±4.19)ms,(58.13±13.27)ms(t=5.828,3.803,all P<0.001).Preoperative Pd,QTc were positively correlated with CHA2DS2-VASc score(P<0.05).After adjus-ting for other factors such as disease course,hypertension,and CHA2DS2-VASc score,△Pd and △QTc re-mained independent influencing factors for early recurrence after PAF RFA(P<0.05).The AUC for △Pd in predicting early recurrence after PAF RFA was 0.779(95%CI:0.689-0.853),with a Youden index of 0.473,sensitivity of 78.57%,and specificity of 68.75%;for △QTc,the AUC was 0.715(95%CI:0.620-0.798),with a Youden index of 0.411,sensitivity of 78.57%,and specificity of 62.50%.The combined pre-diction of △Pd and △QTc for early recurrence after PAF RFA had an AUC of 0.940(95%CI:0.878-0.977),Youden index of 0.779,sensitivity of 92.86%,and specificity of 85.00%,which was superior to ei-ther predictor alone.Conclusion:The changes in ECG Pd and QTc interval before and after RFA in PAF pa-tients have high efficacy in predicting postoperative recurrence and can provide relevant guidance for clinical prevention and treatment.
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