RESUMO
BACKGROUND: The P wave peak time (PWPT) is a predictor of paroxysmal atrial fibrillation (PAF). High-power short-duration ablation has been associated with improved durability of circumferential pulmonary vein electrical isolation (PVI). We investigated the effect of high-power short-duration PVI on PWPT in patients with PAF. METHODS: Out of 111 patients with PAF, 91 received radiofrequency ablation (ablation group) and 20 received medication treatment (control group). A VIZIGO sheath and an STSF catheter (Biosense Webster, CA, USA) were used together for high-power short-duration circumferential PVI at ablation index values of 500 and 400 for the anterior and posterior walls, respectively. The patients were followed up for 12 months. RESULTS: The preoperative PWPT in the ablation group was similar to that in the control group: PWPT IIâ¯= 54.38⯱ 6.18â¯ms vs. 54.35⯱ 6.12â¯ms (pâ¯> 0.05), PWPT V1â¯= 54.19⯱ 6.21â¯ms vs. 54.31⯱ 6.08â¯ms (pâ¯> 0.05), respectively. Circumferential PVI was achieved for all patients in the ablation group during the operation. At the 12-month follow-up, there were seven cases of AF recurrence. The PWPT in the ablation group 12 months postoperatively was shorter than the preoperative value: PWPT IIâ¯= 49.39⯱ 7.11â¯ms vs. 54.38⯱ 6.18â¯ms (pâ¯< 0.001), PWPT V1â¯= 47.69⯱ 7.01â¯ms vs. 54.19⯱ 6.21â¯ms (pâ¯< 0.001). The PWPT in the patients with AF recurrence was significantly longer than that in the non-recurrence patients: PWPT IIâ¯= 50.48⯱ 7.12â¯ms vs. 47.33⯱ 6.21â¯ms (pâ¯< 0.001), PWPT V1â¯= 50.84⯱ 7.05â¯ms vs. 47.19⯱ 6.27â¯ms, (pâ¯< 0.001). The PWPT of the control group at the 12-month follow-up was similar to the baseline level: PWPT IIâ¯= 54.32⯱ 6.20â¯ms vs. 54.35⯱ 6.12â¯ms (pâ¯> 0.05), PWPT V1â¯= 53.89⯱ 6.01â¯ms vs. 54.31⯱ 6.08â¯ms (pâ¯> 0.05). CONCLUSION: The results showed that high-power short-duration PVI had a positive effect on PWPT, which is a predictor of PAF.