Characterization of atrial substrate to predict AF ablation success
| Autor: | M Bergonti, F Spera, T Gonzalez Ferrero, M Nsahlai, H Heidbuchel, M Valderrabano, M Rodriguez Manero, A Sarkozy |
|---|---|
| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | Europace. 25 |
| ISSN: | 1532-2092 1099-5129 |
| DOI: | 10.1093/europace/euad122.001 |
| Popis: | Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): The study has been financially supported by an investigator-initiated research grant by Biosense Webster (Study ID – IIS-532) (MRM) Background Left atrial (LA) substrate may have mechanistic relevance for ablation of atrial fibrillation (AF). We sought to analyze the relationship between low-voltage zones (LVZ), transition-zones (TrZ) and AF recurrence in patients undergoing pulmonary vein isolation (PVI). Methods We conducted a prospective multicenter study on consecutive patients undergoing PVI-only approach. LVZ and TrZ (0.5-1mV) were analyzed offline on high-density electroanatomical maps collected prior to PVI. Results 262 patients (61±11 years, 31% female) with paroxysmal (130 pts) or persistent (132 pts) AF were included. After 28 months of follow-up, 73 (28%) patients experienced recurrence. An extension of more than 5% LVZ in paroxysmal AF and more than 15% in persistent AF were associated with recurrence (HR=4.4 [2.0-9.8], p Conclusions In patients undergoing first PVI, the impact of LVZ on outcomes occurs with lower burden in paroxysmal than persistent AF suggesting that not all LVZs have equal prognostic implications. A proportional area of moderately decreased voltages accompanies LVZ, suggesting a continuous fibrotic substrate instead of the dichotomous division of healthy or diseased tissue. LAVI generally correlates with LVZ but a small subgroup of patients may present with disproportionate atrial remodeling, despite normal LAVI. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|