J 2023

Baseline left atrial low-voltage area predicts recurrence after pulmonary vein isolation: WAVE-MAP AF results

STÁREK, Zdeněk, Di Cori ANDREA, Timothy R BETTS, Gael CLERICI, Daniel GRAS et. al.

Základní údaje

Originální název

Baseline left atrial low-voltage area predicts recurrence after pulmonary vein isolation: WAVE-MAP AF results

Autoři

STÁREK, Zdeněk (203 Česká republika, domácí), Di Cori ANDREA, Timothy R BETTS, Gael CLERICI, Daniel GRAS, Evgeny LYAN, Della Bella PAOLO, Jingyun LI, Benjamin HACK, Laura Zitella VERBICK a Philipp SOMMER

Vydání

EP Europace, Oxford, Oxford University Press, 2023, 1099-5129

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30201 Cardiac and Cardiovascular systems

Stát vydavatele

Velká Británie a Severní Irsko

Utajení

není předmětem státního či obchodního tajemství

Odkazy

Impakt faktor

Impact factor: 6.100 v roce 2022

Kód RIV

RIV/00216224:14110/23:00133681

Organizační jednotka

Lékařská fakulta

UT WoS

001044966200001

Klíčová slova anglicky

Atrial fibrillation; Electroanatomic mapping; Low-voltage area; Pulmonary vein isolation; Catheter ablation

Štítky

Příznaky

Mezinárodní význam, Recenzováno
Změněno: 29. 2. 2024 08:14, Mgr. Tereza Miškechová

Anotace

V originále

Aims Electro-anatomical mapping may be critical to identify atrial fibrillation (AF) subjects who require substrate modification beyond pulmonary vein isolation (PVI). The objective was to determine correlations between pre-ablation mapping characteristics and 12-month outcomes after a single PVI-only catheter ablation of AF. Methods and results This study enrolled paroxysmal AF (PAF), early persistent AF (PsAF; 7 days-3 months), and non-early PsAF (>3-12 months) subjects undergoing de novo PVI-only radiofrequency catheter ablation. Sinus rhythm (SR) and AF voltage maps were created with the Advisor HD Grid & TRADE; Mapping Catheter, Sensor Enabled & TRADE; for each subject, and the presence of low-voltage area (LVA) (low-voltage cutoffs: 0.1-1.5 mV) was investigated. Follow-up visits were at 3, 6, and 12 months, with a 24-h Holter monitor at 12 months. A Cox proportional hazards model identified associations between mapping data and 12-month recurrence after a single PVI procedure. The study enrolled 300 subjects (113 PAF, 86 early PsAF, and 101 non-early PsAF) at 18 centres. At 12 months, 75.5% of subjects were free from AF/atrial flutter (AFL)/atrial tachycardia (AT) recurrence. Univariate analysis found that arrhythmia recurrence did not correlate with AF diagnosis, but LVA was significantly correlated. Low-voltage area (<0.5 mV) >28% of the left atrium in SR [hazard ratio (HR): 4.82, 95% confidence interval (CI): 2.08-11.18; P = 0.0003] and >72% in AF (HR: 5.66, 95% CI: 2.34-13.69; P = 0.0001) was associated with a higher risk of AF/AFL/AT recurrence at 12 months. Conclusion Larger extension of LVA was associated with an increased risk of arrhythmia recurrence. These subjects may benefit from substrate modification beyond PVI.