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Tytuł:
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Quantification of Left Atrial Fibrosis in Patients After Pulmonary Vein Isolation Using the Second-Generation Cryoballoon.
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Autorzy:
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Rottner L; Department of Cardiology, Asklepios Klinik St. Georg.; University Heart and Cardiovascular Care Center Hamburg-Eppendorf.
Heeger CH; Department of Cardiology, Asklepios Klinik St. Georg.; University Heart Center Luebeck, Medical Clinic II (Department of Cardiology, Angiology and Intensive Care Medicine), University Hospital Schleswig-Holstein.
Lemes C; Department of Cardiology, Asklepios Klinik St. Georg.
Wohlmuth P; Department of Cardiology, Asklepios Klinik St. Georg.; Asklepios proresearch.
Maurer T; Department of Cardiology, Asklepios Klinik St. Georg.
Reissmann B; Department of Cardiology, Asklepios Klinik St. Georg.; University Heart and Cardiovascular Care Center Hamburg-Eppendorf.
Fink T; Department of Cardiology, Asklepios Klinik St. Georg.; University Heart Center Luebeck, Medical Clinic II (Department of Cardiology, Angiology and Intensive Care Medicine), University Hospital Schleswig-Holstein.
Mathew S; Department of Cardiology, Asklepios Klinik St. Georg.
Ouyang F; Department of Cardiology, Asklepios Klinik St. Georg.
Kuck KH; Department of Cardiology, Asklepios Klinik St. Georg.
Metzner A; Department of Cardiology, Asklepios Klinik St. Georg.; University Heart and Cardiovascular Care Center Hamburg-Eppendorf.
Rillig A; Department of Cardiology, Asklepios Klinik St. Georg.; Charité, Universitätsmedizin Berlin, Campus Benjamin Franklin.; University Heart and Cardiovascular Care Center Hamburg-Eppendorf.
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Źródło:
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International heart journal [Int Heart J] 2021 Jan 30; Vol. 62 (1), pp. 65-71. Date of Electronic Publication: 2021 Jan 16.
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Typ publikacji:
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Journal Article; Observational Study
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Język:
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English
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Imprint Name(s):
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Original Publication: [Tokyo, Japan] : International Heart Journal Association, [2005]-
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MeSH Terms:
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Atrial Fibrillation/*surgery
Catheter Ablation/*adverse effects
Fibrosis/*complications
Heart Atria/*pathology
Pulmonary Veins/*surgery
Aged ; Atrial Fibrillation/physiopathology ; Catheter Ablation/methods ; Cryosurgery/adverse effects ; Female ; Fibrosis/classification ; Humans ; Male ; Middle Aged ; Recurrence ; Retrospective Studies ; Tachycardia, Supraventricular/epidemiology ; Tachycardia, Supraventricular/etiology ; Treatment Outcome
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Contributed Indexing:
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Keywords: AF ablation; Atrial fibrillation; Clinical outcome; LA fibrosis
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Entry Date(s):
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Date Created: 20210118 Date Completed: 20210204 Latest Revision: 20210204
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Update Code:
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20240105
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DOI:
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10.1536/ihj.20-301
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PMID:
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33455982
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Left atrial (LA) fibrosis is associated with a poor outcome after atrial fibrillation (AF) ablation. This study examined the extent of low-voltage areas in patients with recurrence of atrial tachyarrhythmia (ATA) after CB-based pulmonary vein isolation (PVI).Sixty patients (mean age 67 ± 10 years, n = 32 female; n = 34 paroxysmal AF) who received radiofrequency redo-procedure due to recurrence of ATA within 6 months after CB-based PVI were included. A point-by point 3D-map was performed, and low-voltage sites were delineated based on bipolar voltage < 0.5 mV. The extent of fibrosis was categorized as stage A (0-10% of the LA wall), stage B (10-30%), stage C (30-50%), and stage D (> 50%).The median area of LA low-voltage sites was 28.9 (9; 50.3) cm 2 , corresponding to 17.4 (6; 30.6) % of the LA wall surface. 17/60 (28.3%) patients were categorized as fibrosis stage A, 21/60 (35%) as stage B, 18/60 (30%) as stage C, and 4/60 (6.7%) as stage D. Patient age and LA diameter were associated with more pronounced LA fibrosis; the extent of LA fibrosis was significantly higher in patients with LA tachycardia (LAT) during redo-procedures (P < 0.01), and ablation of linear lesions was more often performed (P < 0.01).In patients after CB2-based PVI, expanded LA tissue fibrosis was associated with the occurrence of LAT and more extensive LA ablation during redo-procedures.
