Abstract Body (Do not enter title and authors here): Background.
A prolonged PR interval has been demonstrated as a predictor of increased risk for incident atrial fibrillation (AF), coronary artery disease, heart failure, and pacemaker implantation.
Purpose.
We aim to investigate the impact of prolonged PR interval > 200 ms on AF recurrence after catheter ablation.
Methods.
We comprehensively searched PubMed, WOS, SCOPUS, EMBASE, and CENTRAL through May 2024. We conducted a pair-wise and prognostic systematic review and meta-analysis with a reconstructed time-to-event data meta-analysis. All analyses were performed using R V. 4.3.1.
Results.
With the inclusion of four studies, our cohort comprised a total of 2,790 patients. Regarding pair-wise meta-analysis, PR interval > 200 ms was significantly associated with an increased incidence of AF recurrence compared to PR interval ≤ 200 ms (RR: 1.50 with 95% CI [1.33, 1.70], P< 0.01). Regarding adjusted prognostic meta-analysis, PR interval > 200 ms was significantly associated with a 92% increase in the risk of AF recurrence compared to PR interval ≤ 200 ms (HR: 1.92 with 95% CI [1.61, 2.30], P< 0.01). Our reconstructed Kaplan Meier showed that a PR interval > 200 ms was significantly associated with a 65% increase in the risk of AF recurrence compared to a PR interval ≤ 200 ms (HR: 1.65 with 95% CI [1.42, 1.92], P< 0.00001) over 120 months follow-up.
Conclusion.
Our meta-analysis concluded that a prolonged PR interval greater than 200 ms is a significant predictor of AF recurrence after catheter ablation, reflecting atrial remodeling, and since the PR interval can be easily measured by a surface 12-lead ECG, patients with a prolonged PR interval may require additional treatment strategies.