Arrhythmias & electrophysiology
Predictor of A4 amplitude using preprocedural electrocardiography in patients with leadless pacemakers
Main finding · Independent predictor of high A4 amplitude (multivariate logistic analysis)Result — go to the resultOdds ratio 0.78 95% CI 0.67–0.92Authors' conclusion
Preoperative electrocardiographic evaluations of P-wave morphology may be useful for predicting A4 amplitude. MDI was the only independent A4 amplitude predictor that seemed promising for selecting Micra-AV patients.
Study context
- Population
- Patients receiving Micra-AV VDD leadless pacemaker implantation, Tottori University Hospital, Nov 2021–Aug 2023 (median age 84 years; 64% male)
- Participants
- 50 patients
- Exposure
- High-A4 vs low-A4
- High-A4n = 26
- Low-A4n = 24reference
- Outcome
- Preoperative predictors of A4 amplitude (ECG P-wave parameters: duration, amplitude, maximum deflection index [MDI], dispersion)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Independent predictor of high A4 amplitude (multivariate logistic analysis)
Odds ratio
0.78
95% CI 0.67–0.92
P = 0.003
High-A4vs low-A4 (median split of A4 amplitude)
OR 0.78 (95% CI 0.67–0.92); P = 0.003
Observational data: associations, not effects.
Further findings
Between-group differences (high-A4 vs low-A4)
- LVEF significantly different
- P = 0.01
- P-wave dispersion significantly different
- P = 0.01
- Maximum deflection index (MDI) significantly different
- P < 0.001
Original publication
Predictor of A4 amplitude using preprocedural electrocardiography in patients with leadless pacemakers. Heart Rhythm. Published 19 February 2024. doi:10.
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