Background: Pre-ablation identification of left atrial (LA) low voltage areas (LVA) among long-standing persistent atrial fibrillation (LSPAF) population remains challenging.
Aims: The aim of the study was to analyze the potential of selected scores originally developed to assess arrhythmia recurrences, thromboembolic complications, or progression from paroxysmal to persistent AF to predict the presence of LA-LVA in LSPAF patients.
Methods: One hundred and fifty-two patients underwent pulmonary vein isolation followed by high-density-high-resolution LA voltage mapping. AF risk scores, such as APPLE, ATLAS, CAAP-AF, DR-FLASH, CHA2DS2-VASc, and HATCH were retrospectively calculated. A receiver operating characteristic curve analysis was performed to evaluate the ability of the scores to predict LVA.
Results: Low voltage areas were detected in 52% of the patients. 28% of the patients with LVA presented severe global LVA burden, whereas 56% of the patients showed a disseminated pattern of remodeling. CAAP-AF ≥7, DR-FLASH ≥4, and CHA2DS2-VASc ≥3 predicted the presence of LVA, whereas ATLAS ≤7 indicated the absence of LVA. ATLAS ≤8, CAAP-AF ≤9, DR-FLASH ≤4, and CHA2DS2-VASc ≤3 predicted the absence of severe LVA. APPLE ≤3 and CHA2DS2-VASc ≤2 predicted the absence of a LVA disseminated pattern. Among predictive scores, ATLAS (AUC, 0.633, 95% CI, 0.543-0.723, P = 0.004), DR-FLASH (AUC, 0.696; 95% CI, 0.594-0.81; P <0.001), and CHA2DS2-VASc (AUC, 0.644; 95% CI 0.518-0.77; P = 0.025) were the best predictors for the absence of LVA, severe LVA and a disseminated pattern of LVA, respectively.
Conclusions: Atrial fibrillation risk stratification with specific scoring systems can unmask the presence of LA-LVA in the LSPAF population.
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http://dx.doi.org/10.33963/KP.15902 | DOI Listing |
Curr Cardiol Rep
January 2025
Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Purpose Of Review: This review aims to explore how a diagnosis of LMNA-related cardiomyopathy (LMNA-CM) informs clinical management, focusing on the prevention and management of its complications, through practical clinical strategies.
Recent Findings: Longitudinal studies have enhanced our understanding of the natural history of LMNA-CM including its arrhythmic and non-arrhythmic complications. A LMNA specific ventricular arrhythmia risk prediction strategy has been integrated into clinical practice guidelines.
Pacing Clin Electrophysiol
January 2025
Department of Cardiology, Saitama Medical University, International Medical Center, Hidaka, Saitama, Japan.
Background: The IntellaNav MiFi OI catheter (MiFi) is equipped with a sensor for local impedance (LI) monitoring and three mini-electrodes. In this study, we investigated the target LI values for a successful pulmonary vein isolation (PVI) under the pacing and ablation technique using the MiFi catheter.
Methods: Twenty-seven patients underwent PVI using the MiFi catheter under mini electrode pacing from the MiFi catheter.
Pacing Clin Electrophysiol
January 2025
Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Milwaukee, Wisconsin, USA.
Background: Concurrent Micra leadless pacemaker (Medtronic, Minneapolis, Minnesota) implantation and atrioventricular node (AVN) ablation has been shown to be feasible and safe in patients with symptomatic, drug-refractory atrial fibrillation (AF). However, major complications within the 30 days after concurrent Micra implantation and AVN ablation have been reported. We evaluated the efficacy and safety of the concurrent procedure at our institution.
View Article and Find Full Text PDFPacing Clin Electrophysiol
January 2025
Department of Cardiology, Yan'an Hospital Affiliated to Kunming Medical University, Kunming, Yunnan, P.R. China.
Objective: The Vizigo sheath, a novel visualizable steerable sheath, has been utilized effectively in the clinical management of atrial fibrillation. However, its application in the ablation of typical atrial flutter (AFL) remains unexplored. This study aims to evaluate and compare the efficacy and safety of the Vizigo sheath against a conventional fixed sheath during catheter ablation for typical AFL.
View Article and Find Full Text PDFJ Cardiovasc Electrophysiol
January 2025
Sakakibara Kinen Byoin, Fuchu, Japan.
Introduction: Freedom from recurrences of atrial tachyarrhythmia (ATA) is suboptimal after pulmonary vein isolation (PVI) in patients with persistent atrial fibrillation (PsAF). This sub-analysis from the Cryo Global Registry sought to investigate predictors of ablation success after PVI using cryoballoon ablation (CBA) for PsAF.
Methods And Results: ATA recurrence was defined as ≥ 30 s recurrence of atrial fibrillation, atrial flutter or atrial tachycardia after a 90-day blanking period and through 12-months.
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