Prolonged signal‐averaged P wave duration after elective cardioversion increases the risk of recurrent atrial fibrillation

Abstract

Objective—To assess the risk of atrial fibrillation (AF) recurrence after elective cardioversion of AF in relation to the signal‐averaged P wave duration (SAPWD), clinical characteristics of the patient, and the duration of the AF disease.

Design—We studied 131 consecutive patients (88 men, 43 women), median age 67 years (range 29–87 years), after elective cardioversion of AF into sinus rhythm. The SAPWD was measured on inclusion, and the follow‐up period was 1 month. Recurrent AF within the first month after cardioversion was regarded as endpoint.

Results—AF recurred in 73 patients (56%). Multiple logistic regression analysis showed that prolonged SAPWD above 160 ms was the only significant risk factor for recurrent AF, OR=2.22 (95% CI 1.07–4.60), p=0.03. There was no significant effect of age, diagnosed hypertension, diagnosed congestive heart failure, dilated left atrium, or long duration of AF on the risk of AF relapse.

Conclusion—Prolonged SAPWD above 160 ms is a risk factor for recurrent AF after elective cardioversion of persistent AF.

• atrial fibrillation
• P wave
• recurrence
• signal‐averaged