ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Cardiac Rhythmology
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1585919
Predictive value of echocardiographic parameter of diastolic dysfunction (Ea/Aa) combined with electrocardiographic P-wave dispersion for the detection of early recurrence of atrial fibrillation after radiofrequency catheter ablation
Provisionally accepted
- 1Hainan Medical University, Haikou, China
- 2First Affiliated Hospital of Hainan Medical University, Haikou, Hainan Province, China
- 3Xiangya School of Medicine, Central South University, Changsha, Hunan Province, China
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Objective: To explore the predictive value of echocardiographic parameters of left-ventricular diastolic function combined with electrocardiographic P-wave dispersion (PWD) for early recurrence of atrial fibrillation (ERAF) after radiofrequency catheter ablation (RFCA). Methods: A total of 145 patients with atrial fibrillation who underwent their first RFCA at the Department of Cardiology, First Affiliated Hospital of Hainan Medical University, between January 2021 and December 2024, were enrolled in the study. The patients were followed up for 3 months after RFCA and divided into two groups, namely those with early recurrence and those without early recurrence. Within 2 hours after the procedure, 12-lead electrocardiogram (ECGs) was recorded. The maximum P-wave duration (Pmax), minimum P-wave duration (Pmin), and PWD (the difference between Pmax and Pmin) were measured. Additionally, left-ventricular diastolic function parameters were obtained via echocardiography. Results: ECG monitoring revealed ERAF in 45 patients (31.03%) at 3-month follow-up after RFCA. Spearman correlation analysis showed that ERAF positively correlated with PWD (r = 0.68, P < 0.001) and negatively correlated with Ea/Aa ratio (r = −0.49, P < 0.001). Under the combination of Ea/Aa < 1 and PWD, the area under the receiver operating characteristic (ROC) curve for the combined prediction increased to 0.95 (95% confidence interval [CI] = 0.91–0.98), with a Youden index of 0.73 (sensitivity 83.83%, specificity 88.88%). The incidence of ERAF was significantly higher in the group with Ea/Aa ratio < 1 than in the group with Ea/Aa ratio ≥ 1 (66.07 vs. 9.09%, P < 0.001). The incidence of ERAF was significantly higher in the group with PWD ≥ 29.5 ms than in the group with PWD < 29.5 ms (65.08 vs. 4.88%, P < 0.001). Ea/Aa ratio and PWD were independently associated with ERAF (for Ea/Aa ratio, adjusted hazard ratio [HR] = 13.48, 95% CI = 3.49–52.05, P < 0.001; for PWD, adjusted HR = 0.23, 95% CI = 0.08–0.62, P = 0.037, respectively). Conclusion: Left-ventricular diastolic dysfunction parameters and PWD can effectively predict ERAF after RCAF. Ea/Aa < 1 and PWD ≥ 29.5 ms are strong and independent predictors of ERAF.
Keywords: Ea/Aa, P-wave dispersion, Atrial Fibrillation, early recurrence, Radiofrequency catheter ablation
Received: 01 Mar 2025; Accepted: 25 Jul 2025.
Copyright: © 2025 Ling, He, Li, Wu, Hou, Wan, Li and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Chufen Lin, Xiangya School of Medicine, Central South University, Changsha, 410008, Hunan Province, China
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