In persistent AF patients with small low voltage areas undergoing ablation, larger LVAs (1.7-4.9 cm2) were associated with a higher prevalence of HFA-PEFF scores 5-6 at 12 months (30% vs 8%, p=0.043).
Cohort (n=62)
Does the extent of small low voltage areas (1.7-4.9 cm2 vs 0.0-1.6 cm2) impact HFpEF status after catheter ablation in patients with persistent atrial fibrillation?
In patients with persistent AF and small LVAs undergoing ablation, relatively larger LVAs (1.7-4.9 cm2) are associated with worse HFpEF profiles at 12 months compared to smaller LVAs (0.0-1.6 cm2), despite similar rhythm outcomes.
Absolute Event Rate: 30% vs 8%
p-value: p=0.043
ABSTRACT Background Low voltage areas (LVAs) in the left atrium (LA) is associated with atrial fibrillation (AF) recurrence and heart failure with preserved ejection fraction (HFpEF). The clinical significance of small LVAs (< 5.0 cm 2 ) in patients with persistent atrial fibrillation (PerAF) remains unclear. This study evaluated the impact of catheter ablation (CA) on HFpEF status in PerAF patients with small LVAs. Methods We included 62 consecutive PerAF patients with total LA LVAs < 5.0 cm 2 undergoing initial CA between June 2019 and March 2023. Patients were divided by the median LVA into the sLVA‐Low (0.0–1.6 cm 2 ) and sLVA‐High (1.7–4.9 cm 2 ). HFA‐PEFF scores were assessed at baseline and 12 months. Changes in HFA‐PEFF scores (ΔHFA‐PEFF), arrhythmia recurrence, and adverse clinical events were compared. Results Baseline HFA‐PEFF scores were higher in sLVA‐High than in sLVA‐Low (4 3–4 vs. 2 2–3, p = 0.013). At 12 months, HFA‐PEFF scores remained elevated in sLVA‐High (3.5 2–5 vs. 2 2–4, p = 0.037), with a greater prevalence of HFA‐PEFF scores 5–6 (30% vs. 8%, p = 0.043). However, ΔHFA‐PEFF scores, AF recurrence rates, the incidence of adverse events did not differ significantly between the two groups. Conclusion Among PerAF patients with small LVAs (<5 cm 2 ), relatively larger LVAs within the small range were associated with worse HFpEF profiles despite similar rhythm outcomes. Even small LVAs may indicate substrate prone to HFpEF progression, warranting careful follow‐up.
Egami et al. (Tue,) conducted a cohort in Persistent atrial fibrillation (PerAF) with small low voltage areas (n=62). sLVA-High (1.7-4.9 cm2) vs. sLVA-Low (0.0-1.6 cm2) was evaluated on Prevalence of HFA-PEFF scores 5-6 at 12 months (p=0.043). In persistent AF patients with small low voltage areas undergoing ablation, larger LVAs (1.7-4.9 cm2) were associated with a higher prevalence of HFA-PEFF scores 5-6 at 12 months (30% vs 8%, p=0.043).