Atrial fibrillation prevalence and atrial vulnerability analysis in paroxysmal supraventricular tachycardia patients after radiofrequency ablation

OBJECTIVE: Paroxysmal supraventricular tachycardia (PSVT) patient has higher prevalence ratio of atrial fibrillation (AF), while AF recurrence remains a high ratio after radiofrequency ablation (RFCA). This study explored AF prevalence and atrial vulnerability in PSVT patients after RFCA, using ROC curve to analyze atrial effective refractory period dispersion (dERP) on postoperative AF in the prediction of PSVT.

PATIENTS AND METHODS: The PSVT patients were enrolled and divided into three groups and received RFCA treatment between January 2010 and December 2014. Group A, AF was induced by programmed electrical stimulation (PES) under isopropyl epinephrine (ISO) perfusion; group B, AF was induced by PES or PES under ISO perfusion; group C, no AF was generated by PES or PES under ISO perfusion. Ultrasonic cardiogram was applied to detect intra, inter, atrial electromechanical delay and dERP. ROC curve was adopted to analyze the prediction effect of dERP on postoperative AF recurrence.

RESULTS: dERP, group B > A > C; inter and intra: group B > A (p<0.05). Logistic regression analysis showed that age, gender, sympathetic nerve stimulation, and left/right atrial diameter were independent risk factors of postoperative AF in PSVT patients (p<0.05). Of note, dERP cut-off value at 75.5 msec can effectively predict AF recurrence in PSVT patients after RFCA (p<0.05).

CONCLUSIONS: Atrial vulnerability index dERP could be applied to evaluate AF recurrence in PSVT patients after RFCA.

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