Key result
Omnipolar mapping of slow anterior left atrial conduction predicts ~40% higher AF recurrence after PVI.
Why the study?
Atrial slow conduction velocity is linked to AF perpetuation, but measurement criteria have not been standardized.
Does the slow conduction velocity area measured by omnipolar technology predict atrial fibrillation recurrence in patients undergoing initial pulmonary vein isolation?
Cohort (n=90)
Does the slow conduction velocity area measured by omnipolar technology predict atrial fibrillation recurrence in patients undergoing initial pulmonary vein isolation?
Answers are grounded in this paper and cite their sources.
Slow conduction velocity area (< 0.7 m/s) in the left atrial anterior wall measured by omnipolar technology is an independent predictor of AF recurrence after initial PVI.
BACKGROUND: Recent studies have shown that atrial slow conduction velocity (CV) is associated with the perpetuation of atrial fibrillation (AF). However, the criteria of CV measurement have not been standardized. The aim of this study was to evaluate the relationship between the slow CV area (SCVA) measured by novel omnipolar technology (OT) and AF recurrence. METHODS: This study included 90 patients with AF who underwent initial pulmonary vein isolation (PVI). The segmented surface area of the SCVA was measured by left atrial (LA) electrophysiological mapping using OT before the PVI. The proportion of the SCVA at each cutoff value of CV (from < 0.6 to < 0.9 m/s) was compared between the patients with and without AF recurrence. RESULTS: During a mean follow-up period of 516 ± 197 days, the recurrence of AF after the initial PVI was observed in 23 (25.5%) patients. In patients with AF recurrence, the proportion of the SCVA in the LA posterior, LA appendage (LAA), and LA anterior were significantly higher than those without AF recurrence. The multivariate analysis indicated that the proportion of the low voltage area and the SCVA in the LA anterior (local CV < 0.7 m/s) were independent predictors of AF recurrence (hazard ratio [HR], 1.07; 95% confidence interval [CI], 1.01-1.14; p = 0.03; HR, 1.40; 95% CI, 1.07-1.83; p = 0.01, respectively). CONCLUSION: By evaluating the local CV using OT, it was indicated that SCVA with CV < 0.7 m/s in the LA anterior is strongly associated with AF recurrence after PVI.
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Okubo et al. (2023) conducted a cohort in Atrial fibrillation (n=90). Slow conduction velocity area (SCVA) measurement using omnipolar technology was evaluated on AF recurrence (HR 1.40, 95% CI 1.07-1.83, p=0.01). Slow conduction velocity area (< 0.7 m/s) in the left atrial anterior measured by omnipolar technology independently predicted AF recurrence after PVI (HR 1.40; 95% CI 1.07-1.83; p=0.01).
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