Zhao Dongsheng, Dong Yan, Chen Qiushi, Ge Gaoyuan, Yadav Nishant, Yang Di, Zhang Fengxiang
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Guangzhou Road 300, Nanjing, 210029, Jiangsu, People's Republic of China.
Department of Cardiology, The Second Affiliated Hospital of Nantong University, Shengli Road 666, Nantong, 226000, Jiangsu, People's Republic of China.
Egypt Heart J. 2025 Jul 31;77(1):77. doi: 10.1186/s43044-025-00664-w.
Left atrial (LA) localized voltage abnormality displayed by electro-anatomic mapping (EAM) has been established as a surrogate marker of atrial fibrosis (AF) which predicts post-ablation recurrence. This study investigates preoperative predictors of LA voltage abnormalities and assesses their impact on atrial fibrillation recurrence following catheter ablation in patients with paroxysmal atrial fibrillation (PAF).
Forty-four (25.6%) patients had LA voltage abnormality which independently predicted post-ablation recurrence (HR 2.85, 95%CI 1.20-6.78, p = 0.02). Larger left atrial diameter (LAD) (OR 1.24 per 1 mm, 95%CI 1.02-1.50, p = 0.03) and higher atrial tachyarrhythmia (ATA) burden (OR 1.02 per 1%, 95%CI 1.00-1.04, p = 0.03) independently correlates with LA voltage abnormality with an ideal combined diagnostic efficiency (AUC 0.80, sensitivity 79.3%, specificity 70.7%, 95% CI 0.70-0.89, p < 0.01).
LA substrate abnormality, even moderate, is an independent risk factor for PAF post-ablation recurrence which can be predicted pre-procedure by LAD and ATA burden.
通过电解剖标测（EAM）显示的左心房（LA）局部电压异常已被确立为心房纤维化（AF）的替代标志物，可预测消融术后复发。本研究调查了LA电压异常的术前预测因素，并评估了它们对阵发性心房颤动（PAF）患者导管消融术后心房颤动复发的影响。
44例（25.6%）患者存在LA电压异常，其可独立预测消融术后复发（风险比2.85，95%置信区间1.20 - 6.78，p = 0.02）。更大的左心房直径（LAD）（每1毫米的比值比为1.24，95%置信区间1.02 - 1.50，p = 0.03）和更高的房性快速性心律失常（ATA）负荷（每1%的比值比为1.02，95%置信区间1.00 - 1.04，p = 0.03）与LA电压异常独立相关，联合诊断效率理想（曲线下面积0.80，敏感性79.3%，特异性70.7%，95%置信区间0.70 - 0.89，p < 0.01）。
LA基质异常，即使是中度异常，也是PAF消融术后复发的独立危险因素，术前可通过LAD和ATA负荷进行预测。
