114 P wave morphology and spectral analysis of signal averaged ECG ’S in paroxysmal AF patients: can this explain anatomical basis of paroxysmal AF and their propensity to recurrence

Background& Purpose: Pulmonary vein isolation (PVI) is an established treatment for paroxysmal atrial fibrillation (PAF) however recurrence can occur despite pulmonary vein (PV) isolation because of abnormal left atrial (LA) substrate which requires additional ablation. Signal averaged ECG ’s have been performed on all patients undergoing ablation for PAF. P wave morphology reflects projection of depolarization vector in three dimensional space nd covers both right and left atrial activation., Bachmann’s bundles is considered most important in interatrail conduction pathway.. We p ostulated that this technique might be used to identify patients with significant atrial substrate change and might give us insight into better understanding of AF substrate. P wave morphologies are mainly classified as type 1 or 2 depending on presence of biphasic P wave in Z axix.
Source: Europace - Category: Cardiology Source Type: research