The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2025
The impact of left atrial voltage abnormality on ablation outcomes in paroxysmal atrial fibrillation and its pre-procedural predictors: an observational retrospective study.
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Zhao Dongsheng, Dong Yan, Chen Qiushi, Ge Gaoyuan, Yadav Nishant, Yang Di, Zhang Fengxiang
Аннотация
BACKGROUND: Left atrial (LA) localized voltage abnormality displayed by electro-anatomic mapping (EAM) has been established as a surrogate marker of atrial fibrosis (AF) which predicts post-ablation recurrence. This study investigates preoperative predictors of LA voltage abnormalities and assesses their impact on atrial fibrillation recurrence following catheter ablation in patients with paroxysmal atrial fibrillation (PAF).
RESULTS: Forty-four (25.6%) patients had LA voltage abnormality which independently predicted post-ablation recurrence (HR 2.85, 95%CI 1.20-6.78, p = 0.02). Larger left atrial diameter (LAD) (OR 1.24 per 1 mm, 95%CI 1.02-1.50, p = 0.03) and higher atrial tachyarrhythmia (ATA) burden (OR 1.02 per 1%, 95%CI 1.00-1.04, p = 0.03) independently correlates with LA voltage abnormality with an ideal combined diagnostic efficiency (AUC 0.80, sensitivity 79.3%, specificity 70.7%, 95% CI 0.70-0.89, p < 0.01).
CONCLUSIONS: LA substrate abnormality, even moderate, is an independent risk factor for PAF post-ablation recurrence which can be predicted pre-procedure by LAD and ATA burden.
RESULTS: Forty-four (25.6%) patients had LA voltage abnormality which independently predicted post-ablation recurrence (HR 2.85, 95%CI 1.20-6.78, p = 0.02). Larger left atrial diameter (LAD) (OR 1.24 per 1 mm, 95%CI 1.02-1.50, p = 0.03) and higher atrial tachyarrhythmia (ATA) burden (OR 1.02 per 1%, 95%CI 1.00-1.04, p = 0.03) independently correlates with LA voltage abnormality with an ideal combined diagnostic efficiency (AUC 0.80, sensitivity 79.3%, specificity 70.7%, 95% CI 0.70-0.89, p < 0.01).
CONCLUSIONS: LA substrate abnormality, even moderate, is an independent risk factor for PAF post-ablation recurrence which can be predicted pre-procedure by LAD and ATA burden.