S Ammar-Busch1,2, A Buiatti3, A Tatzber4, T Reents4, F Bourier4, V Semmler4, M Telishevska4, G Hessling4, I Deisenhofer4. 1. Cardiology Department, Klinikum Coburg GmbH, Ketschendorfer Str. 33, 96450, Coburg, Germany. sonia.busch@klinikum-coburg.de. 2. Department of Electrophysiology, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse 36, Munich, Germany. sonia.busch@klinikum-coburg.de. 3. Klinik für Innere Medizin I, Klinikum rechts der Isar, Technische Universität München, Munich, Germany. 4. Department of Electrophysiology, Deutsches Herzzentrum München, Technische Universität München, Lazarettstrasse 36, Munich, Germany.
Abstract
BACKGROUND: Time has been postulated as an important factor for electrical remodeling of the left atrium (LA) in persistent atrial fibrillation (AF) ('AF begets AF'). However, it is still a matter of debate if structural changes are the cause or consequence of AF. We sought to determine the clinical and invasive parameters, which correlate with LA scar as determined by voltage mapping, in patients with persistent AF. METHODS: Seventy consecutive patients undergoing ablation of persistent (49%) or long-standing persistent AF (51%), between January 2013 and February 2014, were enrolled in the study. Besides clinical parameters, 2D echocardiographic assessment of LA size and LA pressure (LAP) after transseptal puncture was also considered. Bipolar endocardial signals with a mean voltage amplitude < 0.1 mV during AF were defined as LA scar. RESULTS: In the univariable analysis, LA scar was associated with age, gender, coronary artery disease (CAD), glomerular filtration rate (GFR), LA size and LAP. Arrhythmia duration, mild to moderate mitral regurgitation (MR), left ventricular dysfunction and left ventricular hypertrophy showed no significant correlation with atrial scar (all p > 0.05). In a multivariable regression model, LA scar area was independently associated with age, female gender and LA area. AF duration was not associated with LA scar. CONCLUSIONS: In this study, older age, greater LA area and female gender predicted the degree of LA scar, while other variables tested did not. In particular, we found no significant association between AF duration and LA scar.
BACKGROUND: Time has been postulated as an important factor for electrical remodeling of the left atrium (LA) in persistent atrial fibrillation (AF) ('AF begets AF'). However, it is still a matter of debate if structural changes are the cause or consequence of AF. We sought to determine the clinical and invasive parameters, which correlate with LA scar as determined by voltage mapping, in patients with persistent AF. METHODS: Seventy consecutive patients undergoing ablation of persistent (49%) or long-standing persistent AF (51%), between January 2013 and February 2014, were enrolled in the study. Besides clinical parameters, 2D echocardiographic assessment of LA size and LA pressure (LAP) after transseptal puncture was also considered. Bipolar endocardial signals with a mean voltage amplitude < 0.1 mV during AF were defined as LA scar. RESULTS: In the univariable analysis, LA scar was associated with age, gender, coronary artery disease (CAD), glomerular filtration rate (GFR), LA size and LAP. Arrhythmia duration, mild to moderate mitral regurgitation (MR), left ventricular dysfunction and left ventricular hypertrophy showed no significant correlation with atrial scar (all p > 0.05). In a multivariable regression model, LA scar area was independently associated with age, female gender and LA area. AF duration was not associated with LA scar. CONCLUSIONS: In this study, older age, greater LA area and female gender predicted the degree of LA scar, while other variables tested did not. In particular, we found no significant association between AF duration and LA scar.
Entities:
Keywords:
Atrial fibrillation; Low voltage; Three-dimensional mapping system
Authors: Leon Iden; Sonia Busch; Daniel Steven; Roland R Tilz; Dong-In Shin; K R Julian Chun; Heidi Estner; Felix Bourier; David Duncker; Philipp Sommer; Andreas Metzner; Tilman Maurer; Nils-Christian Ewertsen; Henning Jansen; Andreas Rillig; Victoria Johnson; Till Althoff Journal: Herzschrittmacherther Elektrophysiol Date: 2021-07-26
Authors: Valentina A Rossi; Iva Krizanovic-Grgic; Jan Steffel; Daniel Hofer; Thomas Wolber; Corinna B Brunckhorst; Frank Ruschitzka; Firat Duru; Alexander Breitenstein; Ardan M Saguner Journal: Cardiol J Date: 2022-03-14 Impact factor: 3.487