Predictors of low voltage areas in persistent atrial fibrillation: is it really a matter of time?

Ammar-Busch, S; Buiatti, A; Tatzber, A; Reents, T; Bourier, F; Semmler, V; Telishevska, M; Hessling, G; Deisenhofer, I

doi:10.1007/s10840-018-0471-7

journal article

Titel:: Predictors of low voltage areas in persistent atrial fibrillation: is it really a matter of time?
Dokumenttyp:: Journal Article
Autor(en):: Ammar-Busch, S; Buiatti, A; Tatzber, A; Reents, T; Bourier, F; Semmler, V; Telishevska, M; Hessling, G; Deisenhofer, I
Abstract:: BACKGROUND: Time has been postulated as an important factor for electrical remodeling of the left atrium (LA) in persistent atrial fibrillation (AF) ('AF begets AF'). However, it is still a matter of debate if structural changes are the cause or consequence of AF. We sought to determine the clinical and invasive parameters, which correlate with LA scar as determined by voltage mapping, in patients with persistent AF. METHODS: Seventy consecutive patients undergoing ablation of persistent (49%) or long-standing persistent AF (51%), between January 2013 and February 2014, were enrolled in the study. Besides clinical parameters, 2D echocardiographic assessment of LA size and LA pressure (LAP) after transseptal puncture was also considered. Bipolar endocardial signals with a mean voltage amplitude < 0.1 mV during AF were defined as LA scar. RESULTS: In the univariable analysis, LA scar was associated with age, gender, coronary artery disease (CAD), glomerular filtration rate (GFR), LA size and LAP. Arrhythmia duration, mild to moderate mitral regurgitation (MR), left ventricular dysfunction and left ventricular hypertrophy showed no significant correlation with atrial scar (all p > 0.05). In a multivariable regression model, LA scar area was independently associated with age, female gender and LA area. AF duration was not associated with LA scar. CONCLUSIONS: In this study, older age, greater LA area and female gender predicted the degree of LA scar, while other variables tested did not. In particular, we found no significant association between AF duration and LA scar.
Zeitschriftentitel:: J Interv Card Electrophysiol
Jahr:: 2020
Band / Volume:: 57
Heft / Issue:: 3
Seitenangaben Beitrag:: 345-352
Volltext / DOI:: doi:10.1007/s10840-018-0471-7
PubMed:: http://view.ncbi.nlm.nih.gov/pubmed/30374659
Print-ISSN:: 1383-875X
TUM Einrichtung:: Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)2020