Key result
Low-voltage zone extension >5% in paroxysmal AF (HR 4.4; 95% CI 2.0-9.8) and >15% in persistent AF (HR 1.9; 95% CI 1.1-3.7) was associated with increased AF recurrence after pulmonary vein isolation.
Why the study?
Left atrial substrate may have mechanistic relevance for AF ablation, prompting analysis of the relationship between low-voltage zones, transition zones, and AF recurrence after pulmonary vein isolation.
Does the extent of left atrial low-voltage zones predict atrial fibrillation recurrence in patients undergoing pulmonary vein isolation?
Population
262 patients with paroxysmal or persistent AF undergoing pulmonary vein isolation
Comparison
Low-voltage zones and transition zones analyzed on electroanatomical maps before ablation
Design
Prospective multicenter study
Follow-up
28 months
Authors
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LVZ mapping may stratify AF recurrence risk after PVI; hypothesis-generating for substrate-guided ablation, pending randomized trials.
Cohort (n=262)
Yes
Does the extent of left atrial low-voltage zones predict atrial fibrillation recurrence in patients undergoing pulmonary vein isolation?
Hazard Ratio: 4.4 (95% CI 2–9.8)
p-value: p=<0.001
The burden of left atrial low-voltage zones predicting atrial fibrillation recurrence after pulmonary vein isolation is lower in paroxysmal (>5%) compared to persistent (>15%) atrial fibrillation.
Bergonti et al. (2022) conducted a cohort in Atrial fibrillation (n=262). Low-voltage zones (LVZs) extension (>5% in paroxysmal AF, >15% in persistent AF) vs. Lower LVZ extension was evaluated on Atrial fibrillation recurrence (HR 4.4, 95% CI 2.0-9.8, p=<0.001). Low-voltage zone extension >5% in paroxysmal AF (HR 4.4; 95% CI 2.0-9.8) and >15% in persistent AF (HR 1.9; 95% CI 1.1-3.7) was associated with increased AF recurrence after pulmonary vein isolation.
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