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

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.

Basic information

Original name

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

Authors

STÁREK, Zdeněk (203 Czech Republic, belonging to the institution), 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

Edition

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

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

References:

URL

Impact factor

Impact factor: 6.100 in 2022

RIV identification code

RIV/00216224:14110/23:00133681

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1093/europace/euad194

UT WoS

001044966200001

Keywords in English

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

Abstract

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.

Citovat

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. 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.

@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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