{"id":"e9ad856cb2fa","type":"article","url":"https://hartvaat.nl/2023/02/16/p-golfduur-voorspelt-af-recidief-na-catheterablatie-meta-analyse/","title":"P-golfduur voorspelt AF-recidief na catheterablatie: meta-analyse","title_en":"P-wave duration and atrial fibrillation recurrence after catheter ablation: a systematic review and meta-analysis.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":["katheterablatie"],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euac210","source_url":"https://doi.org/10.1093/europace/euac210","authors":["Stergios Intzes","Konstantinos Zagoridis","Marianthi Symeonidou","Emmanouil Spanoudakis","Arash Arya","Borislav Dinov","Nikolaos Dagres","Gerhard Hindricks","Andreas Bollmann","Emmanuel Kanoupakis","Emmanuel Koutalas","Sotirios Nedios"],"significance":5,"published":"2023-02-16","source_date":"2023-02-16","image":"","kennis":[],"congress":"","summary_en":"This meta-analysis confirmed that prolonged P-wave duration on ECG independently predicts AF recurrence after catheter ablation, supporting this simple measure as a pre-ablation risk stratification tool.","created":"2026-07-03T10:30:15Z","updated":"2026-07-03T13:29:19Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Meta-analyse toonde dat een verlengde P-golfduur op het ECG een onafhankelijke voorspeller is van AF-recidief na catheterablatie. Dit eenvoudige ECG-kenmerk kan de patiëntselectie voor ablatie verbeteren.","abstract_original":"AIMS: Atrial fibrillation (AF) is a global health problem with high morbidity and mortality. Catheter ablation (CA) can reduce AF burden and symptoms, but AF recurrence (AFr) remains an issue. Simple AFr predictors like P-wave duration (PWD) could help improve AF therapy. This updated meta-analysis reviews the increasing evidence for the association of AFr with PWD and offers practical implications. METHODS AND RESULTS: Publication databases were systematically searched and cohort studies reporting PWD and/or morphology at baseline and AFr after CA were included. Advanced interatrial block (aIAB) was defined as PWD ≥ 120 ms and biphasic morphology in inferior leads. Random-effects analysis was performed using the Review Manager 5.3 and R programs after study selection, quality assessment, and data extraction, to report odds ratio (OR) and confidence intervals. : Among 4175 patients in 22 studies, 1138 (27%) experienced AFr. Patients with AFr had longer PWD with a mean pooled difference of 7.8 ms (19 studies, P < 0.001). Pooled OR was 2.04 (1.16-3.58) for PWD > 120 ms (13 studies, P = 0.01), 2.42 (1.12-5.21) for PWD > 140 ms (2 studies, P = 0.02), 3.97 (1.79-8.85) for aIAB (5 studies, P < 0.001), and 10.89 (4.53-26.15) for PWD > 150 ms (4 studies, P < 0.001). There was significant heterogeneity but no publication bias detected. CONCLUSION: P-wave duration is an independent predictor for AF recurrence after left atrium ablation. The AFr risk is increasing exponentially with PWD prolongation. This could facilitate risk stratification by identifying high-risk patients (aIAB, PWD > 150 ms) and adjusting follow up or interventions."}