P-wave morphology and electrical activity of the isolated left atrial appendage on 12-lead ECG in patients with recurrent atrial tachyarrhythmias after pulmonary vein isolation

Tina Lin; Andreas Rillig; Andreas Metzner; Shibu Mathew; Christian Heeger; Peter Wohlmuth; Roland Tilz; Karl Heinz Kuck; Feifan Ouyang

doi:10.1007/s10840-017-0287-x

P-wave morphology and electrical activity of the isolated left atrial appendage on 12-lead ECG in patients with recurrent atrial tachyarrhythmias after pulmonary vein isolation

Tina Lin^*, Andreas Rillig, Andreas Metzner, Shibu Mathew, Christian Heeger, Peter Wohlmuth, Roland Tilz, Karl Heinz Kuck, Feifan Ouyang

^*Corresponding author for this work

Clinic of Internal Medicine II - Cardiology

Asklepios Klinik St. Georg

1 Citation (Scopus)

Abstract

Purpose: Left atrial appendage isolation(LAAI) may occur during catheter ablation of complex atrial tachyarrhythmias(aTa). We compare P-waves before and after LAAI and characterize LAA activity on the 12-lead ECG after LAAI. Methods: Twenty-five patients were analyzed after LAAI. P-wave amplitude, duration, and morphology before and after LAAI were analyzed. Automaticity in the isolated LAA was identified, and magnified 12-lead surface ECGs were analyzed for LAA activity, amplitude, duration, and morphology. The isolated LAA area was measured using a 3D mapping system. Results: P-wave amplitude and duration during sinus rhythm was 0.09 mV and 103.57 ms before LAAI and 0.09 mV and 102.25 ms after LAAI, respectively. Precordial leads, I, II, III, and aVF were positive. Lead aVR was negative. Lead aVL was −/+. There were no significant differences in P-wave morphology before and after LAAI. Twenty-one of 25 (84%) patients had LAA automaticity after LAAI. Twelve of 21 (57%) patients had automaticity associated with visible LAA activity on the surface ECG. The average LAA activity amplitude and duration was 0.02 mV and 67.7 ms, respectively. Precordial leads, I, II, III, and aVF were positive. Lead aVR was negative/isoelectric. Lead aVL was positive/isoelectric. The mean isolated LAA area was 29.1 cm². The mean percentage area of isolated LAA vs total LA area was 22.6%. Conclusion: LAA activity can be visible on 12-lead ECG in 57% of patients after LAAI. They have smaller amplitudes and shorter durations compared to P-waves.

Original language	English
Journal	Journal of Interventional Cardiac Electrophysiology
Volume	50
Issue number	2
Pages (from-to)	169-178
Number of pages	10
ISSN	1383-875X
DOIs	https://doi.org/10.1007/s10840-017-0287-x
Publication status	Published - 01.11.2017

Funding

Conflict of interest Tina Lin received travel grants from Biosense Webster, St Jude Medical, Bayer and Topera Inc. and a clinical fellowship from EHRA. Andreas Rillig received travel grants from Biosense, Hansen Medical, and St. Jude Medical and lecture fees from St. Jude Medical and took part at the Boston scientific EP-fellowship; Roland Tilz received Research Grants: Hansen, St. Jude Medical, Travel Grants: St. Jude Medical, Topera, Biosense Webster, Daiichi Sankyo, Sentrheart, Speaker’s Bureau Honoraria: Biosense Webster, Biotronik, Pfizer, Topera, Bristol-Myers Squibb; Bayer, Sanofi Aventis. Prof. Kuck has received research grants from Biosense Webster, Stereotaxis, Prorhythm, Medtronic, Edwards, and Cryocath and is a consultant to St. Jude Medical, Biosense Webster, Prorhythm, and Stereotaxis.

Research Areas and Centers

Centers: Cardiological Center Luebeck (UHZL)

DFG Research Classification Scheme

2.22-12 Cardiology, Angiology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1007/s10840-017-0287-x

Cite this

Lin, T., Rillig, A., Metzner, A., Mathew, S., Heeger, C., Wohlmuth, P., Tilz, R., Kuck, K. H., & Ouyang, F. (2017). P-wave morphology and electrical activity of the isolated left atrial appendage on 12-lead ECG in patients with recurrent atrial tachyarrhythmias after pulmonary vein isolation. Journal of Interventional Cardiac Electrophysiology, 50(2), 169-178. https://doi.org/10.1007/s10840-017-0287-x

@article{0cd899b923544229b558239e3b8913b8,

title = "P-wave morphology and electrical activity of the isolated left atrial appendage on 12-lead ECG in patients with recurrent atrial tachyarrhythmias after pulmonary vein isolation",

abstract = "Purpose: Left atrial appendage isolation(LAAI) may occur during catheter ablation of complex atrial tachyarrhythmias(aTa). We compare P-waves before and after LAAI and characterize LAA activity on the 12-lead ECG after LAAI. Methods: Twenty-five patients were analyzed after LAAI. P-wave amplitude, duration, and morphology before and after LAAI were analyzed. Automaticity in the isolated LAA was identified, and magnified 12-lead surface ECGs were analyzed for LAA activity, amplitude, duration, and morphology. The isolated LAA area was measured using a 3D mapping system. Results: P-wave amplitude and duration during sinus rhythm was 0.09 mV and 103.57 ms before LAAI and 0.09 mV and 102.25 ms after LAAI, respectively. Precordial leads, I, II, III, and aVF were positive. Lead aVR was negative. Lead aVL was −/+. There were no significant differences in P-wave morphology before and after LAAI. Twenty-one of 25 (84\%) patients had LAA automaticity after LAAI. Twelve of 21 (57\%) patients had automaticity associated with visible LAA activity on the surface ECG. The average LAA activity amplitude and duration was 0.02 mV and 67.7 ms, respectively. Precordial leads, I, II, III, and aVF were positive. Lead aVR was negative/isoelectric. Lead aVL was positive/isoelectric. The mean isolated LAA area was 29.1 cm2. The mean percentage area of isolated LAA vs total LA area was 22.6\%. Conclusion: LAA activity can be visible on 12-lead ECG in 57\% of patients after LAAI. They have smaller amplitudes and shorter durations compared to P-waves.",

author = "Tina Lin and Andreas Rillig and Andreas Metzner and Shibu Mathew and Christian Heeger and Peter Wohlmuth and Roland Tilz and Kuck, \{Karl Heinz\} and Feifan Ouyang",

note = "Publisher Copyright: {\textcopyright} 2017, Springer Science+Business Media, LLC.",

year = "2017",

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doi = "10.1007/s10840-017-0287-x",

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Lin, T, Rillig, A, Metzner, A, Mathew, S, Heeger, C, Wohlmuth, P, Tilz, R, Kuck, KH & Ouyang, F 2017, 'P-wave morphology and electrical activity of the isolated left atrial appendage on 12-lead ECG in patients with recurrent atrial tachyarrhythmias after pulmonary vein isolation', Journal of Interventional Cardiac Electrophysiology, vol. 50, no. 2, pp. 169-178. https://doi.org/10.1007/s10840-017-0287-x

P-wave morphology and electrical activity of the isolated left atrial appendage on 12-lead ECG in patients with recurrent atrial tachyarrhythmias after pulmonary vein isolation. / Lin, Tina; Rillig, Andreas; Metzner, Andreas et al.
In: Journal of Interventional Cardiac Electrophysiology, Vol. 50, No. 2, 01.11.2017, p. 169-178.

Research output: Journal Articles › Journal articles › Research › peer-review

TY - JOUR

T1 - P-wave morphology and electrical activity of the isolated left atrial appendage on 12-lead ECG in patients with recurrent atrial tachyarrhythmias after pulmonary vein isolation

AU - Lin, Tina

AU - Rillig, Andreas

AU - Metzner, Andreas

AU - Mathew, Shibu

AU - Heeger, Christian

AU - Wohlmuth, Peter

AU - Tilz, Roland

AU - Kuck, Karl Heinz

AU - Ouyang, Feifan

PY - 2017/11/1

Y1 - 2017/11/1

N2 - Purpose: Left atrial appendage isolation(LAAI) may occur during catheter ablation of complex atrial tachyarrhythmias(aTa). We compare P-waves before and after LAAI and characterize LAA activity on the 12-lead ECG after LAAI. Methods: Twenty-five patients were analyzed after LAAI. P-wave amplitude, duration, and morphology before and after LAAI were analyzed. Automaticity in the isolated LAA was identified, and magnified 12-lead surface ECGs were analyzed for LAA activity, amplitude, duration, and morphology. The isolated LAA area was measured using a 3D mapping system. Results: P-wave amplitude and duration during sinus rhythm was 0.09 mV and 103.57 ms before LAAI and 0.09 mV and 102.25 ms after LAAI, respectively. Precordial leads, I, II, III, and aVF were positive. Lead aVR was negative. Lead aVL was −/+. There were no significant differences in P-wave morphology before and after LAAI. Twenty-one of 25 (84%) patients had LAA automaticity after LAAI. Twelve of 21 (57%) patients had automaticity associated with visible LAA activity on the surface ECG. The average LAA activity amplitude and duration was 0.02 mV and 67.7 ms, respectively. Precordial leads, I, II, III, and aVF were positive. Lead aVR was negative/isoelectric. Lead aVL was positive/isoelectric. The mean isolated LAA area was 29.1 cm2. The mean percentage area of isolated LAA vs total LA area was 22.6%. Conclusion: LAA activity can be visible on 12-lead ECG in 57% of patients after LAAI. They have smaller amplitudes and shorter durations compared to P-waves.

AB - Purpose: Left atrial appendage isolation(LAAI) may occur during catheter ablation of complex atrial tachyarrhythmias(aTa). We compare P-waves before and after LAAI and characterize LAA activity on the 12-lead ECG after LAAI. Methods: Twenty-five patients were analyzed after LAAI. P-wave amplitude, duration, and morphology before and after LAAI were analyzed. Automaticity in the isolated LAA was identified, and magnified 12-lead surface ECGs were analyzed for LAA activity, amplitude, duration, and morphology. The isolated LAA area was measured using a 3D mapping system. Results: P-wave amplitude and duration during sinus rhythm was 0.09 mV and 103.57 ms before LAAI and 0.09 mV and 102.25 ms after LAAI, respectively. Precordial leads, I, II, III, and aVF were positive. Lead aVR was negative. Lead aVL was −/+. There were no significant differences in P-wave morphology before and after LAAI. Twenty-one of 25 (84%) patients had LAA automaticity after LAAI. Twelve of 21 (57%) patients had automaticity associated with visible LAA activity on the surface ECG. The average LAA activity amplitude and duration was 0.02 mV and 67.7 ms, respectively. Precordial leads, I, II, III, and aVF were positive. Lead aVR was negative/isoelectric. Lead aVL was positive/isoelectric. The mean isolated LAA area was 29.1 cm2. The mean percentage area of isolated LAA vs total LA area was 22.6%. Conclusion: LAA activity can be visible on 12-lead ECG in 57% of patients after LAAI. They have smaller amplitudes and shorter durations compared to P-waves.

UR - https://www.scopus.com/pages/publications/85029896736

U2 - 10.1007/s10840-017-0287-x

DO - 10.1007/s10840-017-0287-x

M3 - Journal articles

C2 - 28952048

AN - SCOPUS:85029896736

SN - 1383-875X

VL - 50

SP - 169

EP - 178

JO - Journal of Interventional Cardiac Electrophysiology

JF - Journal of Interventional Cardiac Electrophysiology

IS - 2

ER -

P-wave morphology and electrical activity of the isolated left atrial appendage on 12-lead ECG in patients with recurrent atrial tachyarrhythmias after pulmonary vein isolation

Abstract

Funding

Research Areas and Centers

DFG Research Classification Scheme

UN SDGs

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