Objectives To evaluate whether the amplitude of fibrillatory wave (F wave) on electrocardiography could predict the recurrence in persistent atrial fibrillation (AF) patients who underwent catheter ablation.

Methods All consecutive persistent AF patients who underwent catheter ablation at Peking Union Medical College Hospital between November 2006 and February 2012, were enrolled. The amplitude of F wave was measured on three orthogonal leads (leads I, V1 and aVF) on the Prucka CardioLab recording system. The primary end point was the recurrence after catheter ablation.

Results A total of 54 persistent AF patients were enrolled. Fifty patients (age: 58 ± 11years, 72% male) constituted the study population after excluding four patients lost of follow-up. The duration of AF was 9 ± 7 (2–18) months. Twenty-four patients (48%) recurred during the follow-up of 25 ± 19 months, constituted recurrence group. The remaining 26 patients constituted control group. The F-wave amplitude in recurrence group was significantly lower than control group (lead aVF, 0.085 ± 0.018 vs. 0.111 ± 0.036 mV, P = 0.002; lead V1, 0.116 ± 0.031 vs. 0.148 ± 0.047 mV, P = 0.008). The amplitudes of leads aVF (P = 0.023) and V1 (P = 0.031) were the independent predictors of AF recurrence. The sensitivity and specificity of F-wave amplitude of lead aVF < 0.093 mV or V1 < 0.123 mV to predict the recurrence were 75% and 73%, 68% and 64%, respectively.

Conclusions The low amplitudes of F wave in leads aVF and V1 could predict the recurrence of patients with persistent AF who underwent catheter ablation.