Left atrial low-voltage area size was independently associated with the recurrence of macroreentrant atrial tachycardia after atrial fibrillation ablation (OR 1.21).
Cohort (n=152)
No
Does left atrial low-voltage area size predict the induction and recurrence of macroreentrant atrial tachycardia in patients undergoing AF ablation?
Left atrial low-voltage area size is a significant predictor for the induction and recurrence of macroreentrant atrial tachycardia following AF ablation.
Effect estimate: OR 1.21 (95% CI 1.04-1.51)
p-value: p=0.03
Abstract Background The relationship between induction and recurrence due to atrial tachycardia (AT) and left atrial (LA) matrix progression after atrial fibrillation (AF) ablation remains unclear. Methods One hundred fifty-two consecutive patients with paroxysmal and persistent AF who underwent pulmonary vein isolation (PVI) and cavo-tricuspid isthmus (CTI) ablation and achieved sinus rhythm before the procedure were classified into three groups according to the AT pattern induced after the procedure: group N (non-induced), F (focal pattern), and M (macroreentrant pattern) in 3D mapping. Results The total rate of AT induction was 19.7% (30/152) in groups F ( n = 13) and M ( n = 17). Patients in group M were older than those in groups N and F, with higher CHADS 2 /CHA 2 DS 2 -VASc values, left atrial enlargement, and low-voltage area (LVA) size of LA. The receiver operating characteristic curve determined that the cut-off LVA for macroreentrant AT induction was 8.8 cm 2 (area under the curve AUC: 0.86, 95% confidence interval CI: 0.75–0.97). The recurrence of AT at 36 months in group N was 4.1% (5/122), and at the second ablation, all patients had macroreentrant AT. Patients with AT recurrence in group N had a wide LVA at the first ablation, and the cut-off LVA for AT recurrence was 6.5 cm 2 (AUC 0.94, 95%CI 0.88–0.99). Adjusted multivariate analysis showed that only LVA size was associated with the recurrence of macroreentrant AT (odds ratio 1.21, 95%CI 1.04–1.51). Conclusions It is important to develop a therapeutic strategy based on the LVA size to suppress the recurrence of AT in these patients. Graphical abstract
Sonoda et al. (Tue,) conducted a cohort in Paroxysmal and persistent atrial fibrillation (n=152). Pulmonary vein isolation and cavo-tricuspid isthmus ablation was evaluated on Recurrence of macroreentrant atrial tachycardia (OR 1.21, 95% CI 1.04-1.51, p=0.03). Left atrial low-voltage area size was independently associated with the recurrence of macroreentrant atrial tachycardia after atrial fibrillation ablation (OR 1.21).