What question did this study set out to answer?

To identify and characterize early left atrial structural remodeling using voltage mapping and determine its predictive value for arrhythmia recurrence after pulmonary vein isolation.

April 7, 2017Journal of Cardiovascular Electrophysiology

Identification and electrophysiological characterization of early left atrial structural remodeling as a predictor for atrial fibrillation recurrence after pulmonary vein isolation

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Why the study?

Does the presence of mild abnormal low voltage areas (maLVA <1.1 mV) predict atrial fibrillation recurrence after pulmonary vein isolation in patients without severe low voltage areas?

Population

Patients undergoing pulmonary vein isolation for atrial fibrillation without severe low voltage areas

Design

Cohort

Authors

AYAtsuhiko YagishitaElectrophysiology DSDina M. SparanoNorthwestern University ICIvan CakulevUniversity Hospitals of Cleveland

Discussion

Member takes

Implication

maLVA may identify higher-risk PVI patients; hypothesis-generating for adjunctive ablation trials before practice change.

Key Points

To identify and characterize early left atrial structural remodeling using voltage mapping and determine its predictive value for arrhythmia recurrence after pulmonary vein isolation.
Analyzed left atrial electroanatomical voltage mapping during sinus rhythm using a control-derived voltage cutoff of <1.1 mV to define mild low-voltage areas.
Evaluated patients undergoing pulmonary vein isolation alone who lacked conventional low-voltage areas (<0.5 mV).
Mild low-voltage areas defined by voltages <1.1 mV harbored abnormal electrograms and independently predicted atrial fibrillation recurrence after pulmonary vein isolation alone.
Adjunctive ablation targeting these mildly remodeled, arrhythmogenic substrate areas represents a potential strategy to enhance long-term procedural success.

Structured PICO

Does the presence of mild abnormal low voltage areas (maLVA <1.1 mV) predict atrial fibrillation recurrence after pulmonary vein isolation in patients without severe low voltage areas?

Population

Patients undergoing pulmonary vein isolation (PVI) for atrial fibrillation without severe low voltage areas (LVA < 0.5 mV)

Intervention

Assessment of mild abnormal low voltage areas (maLVA) using a left atrial voltage cutoff of <1.1 mV for electroanatomical voltage mapping in sinus rhythm

Outcome

Atrial fibrillation recurrence after PVI alonehard clinical

Mildly abnormal left atrial low voltage areas (<1.1 mV) independently predict AF recurrence after PVI, suggesting they may serve as a target for adjunctive substrate ablation to improve long-term outcomes.

Cite This Study

Yagishita et al. (2017) studied this question.

synapsesocial.com/papers/69d816fb5c3030ff03d19419 https://doi.org/10.1111/jce.13211

Topics

Atrial fibrillation Persistent AF management AF ablation outcomes

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Identification and electrophysiological characterization of early left atrial structural remodeling as a predictor for atrial fibrillation recurrence after pulmonary vein isolation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Identification and electrophysiological characterization of early left atrial structural remodeling as a predictor for atrial fibrillation recurrence after pulmonary vein isolation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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