How does left atrial substrate change over time following pulmonary vein isolation in patients with atrial fibrillation?
The dynamic nature of left atrial substrate following pulmonary vein isolation suggests that low-voltage zone (LVZ)-based ablation strategies may need to account for substrate regression or progression over time.
Our study describes bidirectional dynamic properties of the LA substrate with concordant either progressive or regressive changes. Regression occurs with reduced AF burden after the first procedure, while progression is associated with persistent AF recurrence despite durable PV isolation. The dynamic nature of LA substrate poses questions about LVZ-based ablation strategies.
Marcon et al. (Tue,) studied this question.
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