Association Between Mean Left Atrial Voltage and Prior Ischemic Stroke in Atrial Fibrillation: A Single-Center Cross-Sectional Study

Figures

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  Figure 1. Flow of the study. Abbreviations: RFCA, radiofrequency catheter ablation.

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  Figure 2. LA voltage in patients with and without prior ischemic stroke. Panel (A) shows that mean LA voltage was significantly lower in patients with prior ischemic stroke compared with those without stroke. Panel (B) shows that LVA% was significantly higher in patients with prior ischemic stroke. Abbreviations: LA, left atrial; LVA%, low-voltage area percentage.

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  Figure 3. Nonlinear association between mean left atrial voltage and low-voltage area percentage. Restricted cubic spline analysis demonstrating the association between mean LA voltage and LVA%. The solid line represents the fitted spline curve and the shaded area indicates the 95% confidence interval. A significant inverse nonlinear association was observed (overall p < 0.001; p for nonlinearity < 0.001). Segmented regression analysis identified a breakpoint at 0.94 mV. Abbreviations: LA, left atrial; LVA%, low-voltage area percentage.

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  Figure 4. Spearman correlation heatmaps demonstrating associations between atrial substrate parameters and clinical variables. Panel (A) shows correlations among continuous variables and atrial substrate parameters. Panel (B) shows correlations between binary clinical characteristics and atrial substrate parameters. The color scale indicates the strength and direction of correlation. Correlation coefficients and corresponding p-values are displayed within each cell. Abbreviations: BMI, body mass index; eGFR, estimated glomerular filtration rate; LA, left atrium/left atrial; LVA%, low-voltage area percentage; NT-proBNP, N-terminal pro B-type natriuretic peptide; PeAF, persistent atrial fibrillation.

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  Figure 5. Receiver operating characteristic curves of mean left atrial voltage and low-voltage area percentage for discriminating prior ischemic stroke. Optimal cut-off values were determined using the Youden index. The blue and red dots indicate the optimal cut-off points for mean LA voltage and LVA%, respectively, and the dashed line represents the line of no discrimination. Abbreviations: AUC, area under the curve; LA, left atrial; LVA%, low-voltage area percentage; ROC, receiver operating characteristic.