B-po02-150 ecg characteristics correlate with clinical hallmarks of atrial remodeling in persistent atrial fibrillation

Previous studies pointed out that ECG organisation indices of patients with persistent atrial fibrillation (peAF) might be affected by clinical and echocardiographic variables, but the results are not consistent throughout studies. We sought to investigate whether clinical predictors of atrial remodelling such as AF duration, age, BMI or left atrial volume (LAV) correlate with the morphology and amplitude of atrial ECG signals in peAF. We studied 52 patients referred for de novo ablation of peAF (sustained duration 9±8m). Dominant frequency (DF) and mean amplitude of f-waves (fWA) were computed on ECG signals devoid of QRST waves recorded at baseline. DF was defined as the highest peak within the power spectrum. Multiple regression analysis was run to predict DF and fWA from sustained AF duration, age, BMI and LAV (measured by 3D-CARTO mapping). For DF, we found: i) an inverse correlation with age, with increasing age linked to lower DF in lead I, II, III, V1 and V6 (r = -0.34 to -0.55, p <0.01; panel A), ii) a direct correlation with LAV in lead V2 (r = 0.34, p < 0.05; panel B) with significant interaction between Age and LAV (p<0.05), and iii) an inverse correlation with LAV (r = -0.30, p = 0.05; panel C) and direct one with BMI (r = 0.29, p = 0.05; panel D) in lead V5. For fWA, we only found an inverse correlation with BMI, with higher BMI significantly associated with lower fWA in lead V1 (r = -0.31, p < 0.05; panel E). Importantly, no correlation between DF and sustained AF duration was observed. This study shows complex interaction between DF values and clinical data in peAF which may explain contradictory results reported in the literature.