Background: The atrial substrate in chronic atrial fibrillation (AF) patients with a left atrial spontaneous echo contrast (LASEC) has not been previously reported. The aim of this study was to investigate the atrial substrate properties and long-term follow-up results in the patients who received catheter ablation of chronic AF.
Methods: Of 36 consecutive patients with chronic AF who received a stepwise ablation approach, 18 patients with an LASEC (group I) were compared with 18 age-gender-left atrial volume matched patients without an LASEC (group II). The atrial substrate properties including the weighted peak-to-peak voltage, total activation time during sinus rhythm (SR), dominant frequency (DF), and complex fractionated electrograms (CFEs) during AF in the bi-atria were evaluated.
Result: The left atrial weighted bipolar peak-to-peak voltage (1.0 ± 0.6 vs 1.6 ± 0.7 mV, P = 0.04), total activation time (119 ± 20 vs 103 ± 13 ms, P < 0.001) and DF (7.3 ± 1.3 vs 6.6 ± 0.7 Hz, P < 0.001) differed between group I and group II, respectively. Those parameters did not differ in the right atrium. The bi-atrial CFEs (left atrium: 89 ± 24 vs 92 ± 25, P = 0.8; right atrium: 92 ± 25 vs 102 ± 3, P = 0.9) did not differ between group I and group II, respectively. After a mean follow-up of 30 ± 13 month, there were significant differences in the antiarrhythmic drugs (1.1 ± 0.3 vs 0.7 ± 0.5, P = 0.02) needed after ablation, and recurrence as persistent AF (92% vs 50%, P = 0.03) between group I and group II, respectively. After multiple procedures, there were more group II patients that remained in SR, when compared with group I (78% vs 44%, P = 0.04).
Conclusion: There was a poorer atrial substrate, lesser SR maintenance after catheter ablation and need for more antiarrhythmic drugs in the chronic AF patients with an LASEC when compared with those without an LASEC.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1111/j.1540-8167.2011.02170.x | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Postablation Arrhythmogenic Channels Predict Atrial Fibrillation Recurrence: Iatrogenic Substrate Revisited.
JACC Clin Electrophysiol
January 2025
Department of Cardiology, Hospital Clínic Cardiovascular Institute (ICCV), Universitat de Barcelona, Barcelona, Catalonia, Spain; Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain. Electronic address:
Optical coherence tomography-enabled classification of the human venoatrial junction.
J Biomed Opt
January 2025
Columbia University, Department of Electrical Engineering, New York, United States.
Significance: Radiofrequency ablation to treat atrial fibrillation (AF) involves isolating the pulmonary vein from the left atria to prevent AF from occurring. However, creating ablation lesions within the pulmonary veins can cause adverse complications.
Aim: We propose automated classification algorithms to classify optical coherence tomography (OCT) volumes of human venoatrial junctions.
A tailored substrate-based approach using focal pulsed field catheter ablation in patients with atrial fibrillation and advanced atrial substrate: Procedural data and 6-months success rates.
Heart Rhythm
January 2025
Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM), Maastricht University Medical Centre, Maastricht, The Netherlands; Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark. Electronic address:
Background: Focal pulsed-field ablation (F-PFA) integrated in electroanatomical mapping (EAM) systems allows tailored lesion sets in patients with atrial fibrillation (AF).
Objective: To determine feasibility, safety and 6-months outcome of F-PFA for a tailored substrate-based catheter ablation (CA) approach in patients with AF and advanced atrial substrate.
Methods: Consecutive patients with AF and advanced atrial substrate treated by a F-PFA system (Cardiofocus) through contact-force sensing catheters integrated in EAM systems were prospectively enrolled.
A catheter ablation case of confluent inferior and left superior pulmonary veins: a rare pulmonary vein variation.
J Interv Card Electrophysiol
January 2025
Department of Cardiology, Sapporo Kosei General Hospital, 8-5 Kita 3 Jo Higashi, Chuo-Ku, Sapporo City, Hokkaido, Japan.
Pulmonary vein (PV) variations are commonly detected by preoperative imaging modalities in catheter ablation for atrial fibrillation. However, rare variations that have not been previously reported exist. The present case is the first reported instance of three PVs originating from a common trunk.
View Article and Find Full Text PDFPeak Frequency Analysis and Functional Substrate Mapping to Predict Critical Isthmus of Atypical Atrial Tachycardia; Findings from a Novel Automated Annotation Algorithm to Detect Near Field Signals.
Heart Rhythm
January 2025
Hacettepe University, Faculty of Medicine, Department of Cardiology, Ankara, Turkey.
Background: Atypical atrial tachycardia (AT) is a commonly encountered rhythm disorder especially in patients with underlying atrial scar. Peak frequency (PF) annotation of bipolar electrograms is a novel method, which mainly aims to discriminate near-field and far-field signals.
Objective: To evaluate the association between PF annotation of low-voltage zones (LVZ) and deceleration zones (DZ) during sinus / paced rhythm and their role to predict the critical isthmus (CI) and termination sites of atypical ATs.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!