Extent and magnitude of low-voltage areas assessed by ultra-high-density electroanatomical mapping correlate with left atrial function

International Journal of Cardiology
F HohendannerA S Parwani

Abstract

The extent of left atrial (LA) adverse remodeling as a cardiac disease marker has become increasingly important. In patients with atrial fibrillation (AF), atrial remodeling (AR) is accompanied by increased mortality. The relation between LA function and the extent of low-voltage areas (LVAs) has not yet been systematically investigated. In patients with AF undergoing catheter-ablation, LA was studied using echocardiography and ultra-high-density mapping (Rhythmia®). Fibrosis (i.e. extent of LVAs) was estimated by quantifying areas with bipolar electrogram amplitudes of ≤0.5, ≤0.4, ≤0.3, ≤0.2 or ≤0.1 mV. A total of 22 patients with a mean LVEF of 53 ± 2% was studied. Mean LA volume index (LAVI) was significantly increased at 39 ± 3 ml/m2 indicating AR. Size of LVAs was 57 ± 7 cm2 representing 47 ± 5% of the total LA area (low-voltage set to ≤0.5 mV). With low-voltage set to ≤0.4, ≤0.3, ≤0.2 and ≤0.1, total area decreased to 34 ± 6, 28 ± 6, 22 ± 5 and 12 ± 3 cm2. LAVI positively correlated with the extent of LVAs at all cut-offs. Mean LA emptying fraction was 42 ± 3% and showed a negative correlation with LVAs with low-voltage set to ≤0.4 mV. Moreover, mean LA strain was 13 ± 2% and correlated with LVAs with low-voltage at all c...Continue Reading

Citations

Dec 6, 2018·Current Opinion in Cardiology·Yenn-Jiang LinShih-Ann Chen
Aug 15, 2019·Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing·Yosuke NakataniKoichiro Kinugawa
Jan 18, 2020·Journal of the American College of Cardiology·Felipe BisbalAntoni Bayés-Genís
Mar 12, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Robert SchönbauerChristopher Piorkowski
Apr 30, 2021·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Martin EichenlaubAmir Jadidi
May 11, 2021·Journal of Cardiovascular Electrophysiology·Satoshi HayashidaYasuo Okumura

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