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@article{2379800,
author = {Stárek, Zdeněk and Andrea, Di Cori and Betts, Timothy R and Clerici, Gael and Gras, Daniel and Lyan, Evgeny and Paolo, Della Bella and Li, Jingyun and Hack, Benjamin and Verbick, Laura Zitella and Sommer, Philipp},
article_location = {Oxford},
article_number = {9},
doi = {http://dx.doi.org/10.1093/europace/euad194},
keywords = {Atrial fibrillation; Electroanatomic mapping; Low-voltage area; Pulmonary vein isolation; Catheter ablation},
language = {eng},
issn = {1099-5129},
journal = {EP Europace},
title = {Baseline left atrial low-voltage area predicts recurrence after pulmonary vein isolation: WAVE-MAP AF results},
url = {https://academic.oup.com/europace/article/25/9/euad194/7226767?login=true},
volume = {25},
year = {2023}
}
TY - JOUR
ID - 2379800
AU - Stárek, Zdeněk - Andrea, Di Cori - Betts, Timothy R - Clerici, Gael - Gras, Daniel - Lyan, Evgeny - Paolo, Della Bella - Li, Jingyun - Hack, Benjamin - Verbick, Laura Zitella - Sommer, Philipp
PY - 2023
TI - Baseline left atrial low-voltage area predicts recurrence after pulmonary vein isolation: WAVE-MAP AF results
JF - EP Europace
VL - 25
IS - 9
SP - 1-11
EP - 1-11
PB - Oxford University Press
SN - 10995129
KW - Atrial fibrillation
KW - Electroanatomic mapping
KW - Low-voltage area
KW - Pulmonary vein isolation
KW - Catheter ablation
UR - https://academic.oup.com/europace/article/25/9/euad194/7226767?login=true
N2 - 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.
ER -
STÁREK, Zdeněk, Di Cori ANDREA, Timothy R BETTS, Gael CLERICI, Daniel GRAS, Evgeny LYAN, Della Bella PAOLO, Jingyun LI, Benjamin HACK, Laura Zitella VERBICK and Philipp SOMMER. Baseline left atrial low-voltage area predicts recurrence after pulmonary vein isolation: WAVE-MAP AF results. \textit{EP Europace}. Oxford: Oxford University Press, 2023, vol.~25, No~9, p.~1-11. ISSN~1099-5129. Available from: https://dx.doi.org/10.1093/europace/euad194.
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