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Electrical Remodeling of Left Atrium Is a Better Predictor for Recurrence Than Structural Remodeling in Atrial Fibrillation Patients Undergoing Radiofrequency Catheter Ablation

BACKGROUND AND OBJECTIVES: Recurrence rates after radiofrequency catheter ablation (RFCA) in atrial fibrillation (AF) patients are not low especially in non-paroxysmal AF. The diameter of left atrium (LA) has been widely used to predict the recurrence after RFCA for decades. However, LA diameter rep...

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Autores principales: Kim, Yun Gi, Choi, Ha Young, Shim, Jaemin, Min, Kyongjin, Choi, Yun Young, Choi, Jong-Il, Kim, Young-Hoon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Cardiology 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9064696/
https://www.ncbi.nlm.nih.gov/pubmed/35129318
http://dx.doi.org/10.4070/kcj.2021.0323
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author Kim, Yun Gi
Choi, Ha Young
Shim, Jaemin
Min, Kyongjin
Choi, Yun Young
Choi, Jong-Il
Kim, Young-Hoon
author_facet Kim, Yun Gi
Choi, Ha Young
Shim, Jaemin
Min, Kyongjin
Choi, Yun Young
Choi, Jong-Il
Kim, Young-Hoon
author_sort Kim, Yun Gi
collection PubMed
description BACKGROUND AND OBJECTIVES: Recurrence rates after radiofrequency catheter ablation (RFCA) in atrial fibrillation (AF) patients are not low especially in non-paroxysmal AF. The diameter of left atrium (LA) has been widely used to predict the recurrence after RFCA for decades. However, LA diameter represents structural remodeling of LA and does not reflect electrical remodeling. We aimed to determine the predictive value of electrical remodeling of LA which is represented by the amount of low voltage zone (LVZ). METHODS: We performed a retrospective cohort analysis of AF patients who underwent de novo RFCA in a single-center. RESULTS: A total of 3,120 AF patients with de novo RFCA were analyzed. Among these patients, 537 patients underwent an electroanatomic mapping with bipolar voltage measurement of LA. The diameter of LA and flow velocity of LA appendage (LAA) differed significantly according to quartile group of LVZ area and percentage: patients with high LVZ had large LA diameter and low LAA flow velocity (p<0.001). Freedom from late recurrence (LR) was significantly lower in patients with high LVZ area and percentage (p<0.001). The diameter and surface area of LA had area under curve (AUC) of 0.592 and 0.593, respectively (p=0.002 for both). The predictive value of LVZ area (AUC, 0.676) and percentage (AUC, 0.671) were both superior compared with LA diameter (p=0.011 and 0.027 for each comparison). CONCLUSIONS: In conclusion, LVZ can predict freedom from LR after RFCA in AF patients. Predictive value was higher in parameters reflecting electrical rather than structural remodeling of LA.
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spelling pubmed-90646962022-05-10 Electrical Remodeling of Left Atrium Is a Better Predictor for Recurrence Than Structural Remodeling in Atrial Fibrillation Patients Undergoing Radiofrequency Catheter Ablation Kim, Yun Gi Choi, Ha Young Shim, Jaemin Min, Kyongjin Choi, Yun Young Choi, Jong-Il Kim, Young-Hoon Korean Circ J Original Research BACKGROUND AND OBJECTIVES: Recurrence rates after radiofrequency catheter ablation (RFCA) in atrial fibrillation (AF) patients are not low especially in non-paroxysmal AF. The diameter of left atrium (LA) has been widely used to predict the recurrence after RFCA for decades. However, LA diameter represents structural remodeling of LA and does not reflect electrical remodeling. We aimed to determine the predictive value of electrical remodeling of LA which is represented by the amount of low voltage zone (LVZ). METHODS: We performed a retrospective cohort analysis of AF patients who underwent de novo RFCA in a single-center. RESULTS: A total of 3,120 AF patients with de novo RFCA were analyzed. Among these patients, 537 patients underwent an electroanatomic mapping with bipolar voltage measurement of LA. The diameter of LA and flow velocity of LA appendage (LAA) differed significantly according to quartile group of LVZ area and percentage: patients with high LVZ had large LA diameter and low LAA flow velocity (p<0.001). Freedom from late recurrence (LR) was significantly lower in patients with high LVZ area and percentage (p<0.001). The diameter and surface area of LA had area under curve (AUC) of 0.592 and 0.593, respectively (p=0.002 for both). The predictive value of LVZ area (AUC, 0.676) and percentage (AUC, 0.671) were both superior compared with LA diameter (p=0.011 and 0.027 for each comparison). CONCLUSIONS: In conclusion, LVZ can predict freedom from LR after RFCA in AF patients. Predictive value was higher in parameters reflecting electrical rather than structural remodeling of LA. The Korean Society of Cardiology 2021-12-21 /pmc/articles/PMC9064696/ /pubmed/35129318 http://dx.doi.org/10.4070/kcj.2021.0323 Text en Copyright © 2022. The Korean Society of Cardiology https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Kim, Yun Gi
Choi, Ha Young
Shim, Jaemin
Min, Kyongjin
Choi, Yun Young
Choi, Jong-Il
Kim, Young-Hoon
Electrical Remodeling of Left Atrium Is a Better Predictor for Recurrence Than Structural Remodeling in Atrial Fibrillation Patients Undergoing Radiofrequency Catheter Ablation
title Electrical Remodeling of Left Atrium Is a Better Predictor for Recurrence Than Structural Remodeling in Atrial Fibrillation Patients Undergoing Radiofrequency Catheter Ablation
title_full Electrical Remodeling of Left Atrium Is a Better Predictor for Recurrence Than Structural Remodeling in Atrial Fibrillation Patients Undergoing Radiofrequency Catheter Ablation
title_fullStr Electrical Remodeling of Left Atrium Is a Better Predictor for Recurrence Than Structural Remodeling in Atrial Fibrillation Patients Undergoing Radiofrequency Catheter Ablation
title_full_unstemmed Electrical Remodeling of Left Atrium Is a Better Predictor for Recurrence Than Structural Remodeling in Atrial Fibrillation Patients Undergoing Radiofrequency Catheter Ablation
title_short Electrical Remodeling of Left Atrium Is a Better Predictor for Recurrence Than Structural Remodeling in Atrial Fibrillation Patients Undergoing Radiofrequency Catheter Ablation
title_sort electrical remodeling of left atrium is a better predictor for recurrence than structural remodeling in atrial fibrillation patients undergoing radiofrequency catheter ablation
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9064696/
https://www.ncbi.nlm.nih.gov/pubmed/35129318
http://dx.doi.org/10.4070/kcj.2021.0323
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