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ȣ - 540714 102 |
P wave changes after circumferential pulmonary vein isolation (CPVI) with roof and posterior line and Bachmann bundle block. |
가톨릭대학교 순환기내과 |
최민석, 오용석, 신우승, 장성원, 김지훈, 윤호중, 정욱성, 이만영, 승기배, 노태호, 김재형 |
Background: The effect of circumferential pulmonary vein isolation (CPVI) with both roof line and posterior line and additional Bachmann bundle block (BBB) on P wave characteristics is not unknown.
Aims: To assess the influence of staged left atrial isolation on P wave changes.
Methods: Twenty four patients (58±14 yrs, 17 males) underwent CPVI with both roof and posterior line and anterior line for non-paroxysmal atrial fibrillation. P wave duration and peak p wave voltage were measured at the start of procedure and after CPVI with both roof and posterior line and end of Bachmann bundle block.
Results: P wave duration increased from 144±27 ms to 149±28 ms after CPVI and both roof and posterior line and eventually to 166±33 ms after BBB (p=0.09). Significant peak p wave voltage increase was seen in lead V1 (0.08±0.03 mV vs.0.11±0.03 mV vs. 0.11±0.04 mV, p=0.0034). Peak p
wave voltages showed increased tendency after ablation procedure in lead V1,V2 and V3 and decreased tendency in lead V5 and V6 (Table 1).
Conclusion: CPVI with both roof and posterior line and Bachmann bundle block results in increased p wave duration and and p wave volatage gain in precordial lead V1,2,3 and voltage loss in lead V5,6.
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Initial |
s/p CPVI with both roof and posterior line |
s/p Bachman bundle block |
P value |
Lead I |
0.07±0.02 |
0.07±0.03 |
0.57±0.04 |
0.26 |
Lead II |
0.12±0.04 |
0.12±0.03 |
0.12±0.04 |
0.86 |
Lead III |
0.11±0.17 |
0.08±0.04 |
0.10±0.16 |
0.90 |
Lead aVR |
0.11±0.03 |
0.12±0.03 |
0.11±0.04 |
0.22 |
Lead aVL |
0.04±0.03 |
0.04±0.04 |
0.03±0.03 |
0.45 |
Lead aVF |
0.09±0.04 |
0.09±0.03 |
0.09±0.02 |
0.20 |
Lead V1 |
0.08±0.03 |
0.11±0.01 |
0.11±0.04 |
0.003 |
Lead V2 |
0.09±0.03 |
0.11±0.04 |
0.11±0.04 |
0.18 |
Lead V3 |
0.08±0.02 |
0.09±0.03 |
0.14±0.19 |
0.36 |
Lead V4 |
0.10±0.12 |
0.08±0.02 |
0.11±0.15 |
0.58 |
Lead V5 |
0.08±0.11 |
0.07±0.03 |
0.06±0.03 |
0.91 |
Lead V6 |
0.08±0.11 |
0.06±0.02 |
0.06±0.02 |
0.78 | Table1. Peak P wave voltage changes during catheter ablation
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