Correlation Analysis Of P-wave Terminal Force In Lead V1(PTFV1) With HATCH Score

Objective:Current risk scoring system for the progression of paroxysmal atrialfibrillation to persistent atrial fibrillation are rare, Some scholars even thought thatparoxysmal atrial fibrillation and persistent atrial fibrillation were two kinds of disease.In2010, De Vos was first reported the HATCH score, which one risk scoring system canevaluate the progression of paroxysmal atrial fibrillation to persistent atrial fibrillation.HATCH score include five risk factors. HATCH score have limitations, because it wasmade of history data, and the subjectivity of some variables is larger, HATCH score waslack of objective examination index. This study assumes that the ECG examination canidentify the patients of high-risk progress from paroxysmal atrial fibrillation topersistent atrial fibrillation. By analyzing the correlation of P-wave terminal force inlead V1(PTFV1) and paroxysmal atrial fibrillation progression risk scoring system(HATCH score), provide a new prediction method of risk of progression in patients withparoxysmal atrial fibrillation.Methods:We reviewed and Statistics HATCH score and PTFV1in180non-valvularparoxysmal atrial fibrillation patients in the First affiliated hospital of Dalian medicaluniversity during2011to2012and analyzed correlation of PTFV1and HATCH scoreby using Spearman rank. According to HATCH score of0、1and≥2，We divided thecases into3groups. According to the outcome of atrial fibrillation，We divided the casesinto the persistent atrial fibrillation group by progressing from paroxysmal atrialfibrillation (Progressive group) and the Paroxysmal atrial fibrillation groupstill(Paroxysmal group). According to the cause of atrial fibrillation，We divided thecases into the pathological atrial fibrillation group (pathological group) and the Loneatrial fibrillation group (isolated group). we statistical analysis on the above each group respectively. Persistent atrial fibrillation as the judgment standard for progress，ROCcurve drawing，select the best point，and calculating the area under the curve andsensitivity、specificity.Results:(1) PTFV1and HATCH score was significantly and positively correlated（r=0.550，P <0.01） in180non-valvular paroxysmal atrial fibrillation patients.(2)ThePTFV1of the group which HATCH score is1was slightly larger than PTFV1of thegroup which HATCH score is0, but the PTFV1come from two groups had nosignificant difference （P>0.05）；PTFV1of the group which HATCH score≥2wassignificantly higher than that of the group which HATCH score in1, and the differencewas statistically significant (P <0.01).(3)After an average of1year’s follow-up，HATCH score and PTFV1in the persistent atrial fibrillation group by progressingfrom paroxysmal atrial fibrillation (Progressive group) was significantly higher than theParoxysmal atrial fibrillation group still(Paroxysmal group),and the difference wasstatistically significant（P <0.05，P <0.01）.(4) HATCH score and PTFV1in thepathological atrial fibrillation group (pathological group) was significantly higher thanthe Lone atrial fibrillation group (isolated group),and the difference was statisticallysignificant（P <0.01，P <0.01）.(5)0.07as the best critical point on the ROC curve,PTFV1>0.070mm s predicted the risk of progression of atrial fibrillation whichsensitivity was70%,the specificity was81.8%,the area under the curve was0.876, thedifference comparing withAUC=0.5was statistically significant (95%CI0.794to0.959, P <0.01).Conclusion: PTFV1and HATCH score was significantly and positively correlated inparoxysmal atrial fibrillation patients，and with the HATCH score higher, PTFV1absolute value also increases accordingly; PTFV1as a noninvasive indicator forpredicting the progression of paroxysmal atrial fibrillation to persistent atrial fibrillationhas important clinical significance.