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Left Atrial Low-Voltage Areas Predict the Risk of Atrial Fibrillation Recurrence after Radiofrequency Ablation.

作者信息

Mitran Raluca-Elena, Popa-Fotea Nicoleta-Monica, Iorgulescu Corneliu, Nastasa Alexandrina, Pupaza Adelina, Gondos Viviana, Petre Ioana-Gabriela, Paja Steliana-Cosmina, Vatasescu Radu-Gabriel

机构信息

Department of Cardiology, Clinic Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania.

Department IV-Cardio-Thoracic Pathology, Carol Davila University of Medicine and Pharmacy, Eroii Sanitari Bvd. 8, 050474 Bucharest, Romania.

出版信息

Biomedicines. 2023 Dec 9;11(12):3261. doi: 10.3390/biomedicines11123261.


DOI:10.3390/biomedicines11123261
PMID:38137482
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10740849/
Abstract

Atrial fibrillation (AF), the most frequently encountered arrhythmia worldwide, is associated with increased cardiovascular morbidity and mortality. Left atrial (LA) and antral region of the pulmonary veins (PVs) remodeling are risk factors for AF perpetuation. Among the methods of LA fibrosis quantification, bipolar voltage mapping during three-dimensional electro-anatomical mapping is less studied. The main aim of this study was to analyze the relationship between the degree of LA fibrosis quantified in low-voltage areas and the efficacy of AF radiofrequency catheter ablation. All consecutive patients with AF ablation were included, and the degree of LA fibrosis was measured based on the low-voltage areas in the LA and the antral region of PVs (<0.5 mV for patients in sinus rhythm and <0.25 mV for patients in AF at the time of the ablation procedure). The efficacy of AF ablation was determined by the rate of recurrence after a blanking period of three months. A total of 106 patients were included; from these, 38 (35.8%) had AF recurrence after RF ablation, while 68 (64.2%) were free of events. The area and percentage of LA fibrosis were significantly higher in the patients with AF recurrence ( = 0.018 and = 0.019, respectively). However, no significant differences were found between the patients with and without AF recurrence in terms of the area and percentage of PVs fibrosis ( = 0.896 and = 0.888, respectively). Moreover, LA fibrosis parameters proved to be excellent predictors for AF recurrence (areas under the curve of 0.834 and 0.832, respectively, < 0.001) even after adjustment for LA indexed volume and CHADS-VASc score. In conclusion, LA fibrosis measured on bipolar voltage maps increases the risk of AF recurrence after the RF catheter ablation procedure.

摘要

相似文献

[1]
Left Atrial Low-Voltage Areas Predict the Risk of Atrial Fibrillation Recurrence after Radiofrequency Ablation.

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[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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[10]
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引用本文的文献

[1]
Targeting the Substrate: Mechanism-Based Ablation Strategies for Persistent Atrial Fibrillation.

J Clin Med. 2025-7-20

[2]
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Heart Rhythm O2. 2025-2-7

[3]
The FUNCTION Study: A Randomized Controlled Trial on the Efficacy of Sacubitril/Valsartan on the Success Rate of Catheter Ablation for Nonparoxysmal Atrial Fibrillation.

Cardiovasc Drugs Ther. 2025-5-7

[4]
Individually designed ablation of low-voltage areas in persistent atrial fibrillation-a randomized controlled trial (IDEAL-AF): study design and rationale.

Eur Heart J Open. 2025-4-11

[5]
Telomere Length Is Associated With Adverse Atrial Remodeling in Patients With Atrial Fibrillation.

J Am Heart Assoc. 2025-2-4

[6]
Left Atrial Low-Voltage Extent Predicts the Recurrence of Supraventricular Arrhythmias.

J Cardiovasc Dev Dis. 2024-10-21

[7]
Automatic Echocardiographic Assessment of Left Atrial Function for Prediction of Low-Voltage Areas in Non-Valvular Atrial Fibrillation.

Int J Gen Med. 2024-10-2

本文引用的文献

[1]
Impact of Percutaneous Mitral Valve Repair on Left Atrial Strain and Atrial Fibrillation Progression.

J Cardiovasc Dev Dis. 2023-7-28

[2]
Low voltage area guided substrate modification in nonparoxysmal atrial fibrillation: A systematic review and meta-analysis.

J Cardiovasc Electrophysiol. 2023-2

[3]
Correlation between Cardiac MRI and Voltage Mapping in Evaluating Atrial Fibrosis: A Systematic Review.

Radiol Cardiothorac Imaging. 2022-10-13

[4]
2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC.

Eur Heart J. 2021-2-1

[5]
High-power application is associated with shorter procedure time and higher rate of first-pass pulmonary vein isolation in ablation index-guided atrial fibrillation ablation.

J Cardiovasc Electrophysiol. 2019-10-21

[6]
Histopathological Characterization of Radiofrequency Ablation in Ventricular Scar Tissue.

JACC Clin Electrophysiol. 2019-6-26

[7]
Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association.

Circulation. 2019-3-5

[8]
Longer Duration Versus Increasing Power During Radiofrequency Ablation Yields Different Ablation Lesion Characteristics.

JACC Clin Electrophysiol. 2018-5-10

[9]
Improving procedural and one-year outcome after contact force-guided pulmonary vein isolation: the role of interlesion distance, ablation index, and contact force variability in the 'CLOSE'-protocol.

Europace. 2018-11-1

[10]
Left atrial strain predicts recurrence of atrial arrhythmias after catheter ablation of persistent atrial fibrillation.

Open Heart. 2017-4-28

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