Prognostic impact of atrial cardiomyopathy : Long-term follow-up of patients with and without low-voltage areas following atrial fibrillation ablation
Copyright © 2023 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved..
BACKGROUND: Atrial cardiomyopathy is known as an underlying pathophysiological factor in the majority of patients with atrial fibrillation (AF). Left atrial low-voltage areas (LVAs) are reported to coincide with fibrosis and likely represent atrial cardiomyopathy.
OBJECTIVE: The purpose of this study was to delineate differences in the long-term prognosis of patients stratified by the size of LVAs.
METHODS: This observational study included 1488 consecutive patients undergoing initial ablation for AF. LVAs were defined as regions with a bipolar peak-to-peak voltage <0.50 mV. The total study population was divided into 3 groups stratified by LVA size: patients with no LVAs (n = 1136); those with small (<20 cm2) LVAs (n = 250) LVAs; and those with extensive (≥20 cm2) LVAs (n = 102). Composite endpoints of death, heart failure, and stroke were followed for up to 5 years.
RESULTS: Composite endpoints developed in 105 of 1488 patients (7.1%), and AF recurrence occurred in 410 (27.6%). Composite endpoints developed more frequently in the order of patients with extensive LVAs (19.1%), small LVAs (10.8%), and no LVAs (5.1%) (P for trend <.0001). Multivariable analysis revealed that LVA presence was independently associated with higher incidence of composite endpoints, irrespective of AF recurrence (modified hazard ratio 1.73; 95% confidence interval 1.13-2.64; P = .011) CONCLUSION: LVA presence and its extent both were associated with poor long-term composite endpoints of death, heart failure, and stroke, irrespective of AF recurrence or other confounders. Underlying atrial cardiomyopathy seems to define a poor prognosis after AF ablation.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:21 |
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| Enthalten in: |
Heart rhythm - 21(2024), 4 vom: 29. Apr., Seite 378-386 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Masuda, Masaharu [VerfasserIn] |
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| Links: |
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| Themen: |
Atrial cardiomyopathy |
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| Anmerkungen: |
Date Completed 01.04.2024 Date Revised 01.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.hrthm.2023.12.016 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM366485679 |
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| 100 | 1 | |a Masuda, Masaharu |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Prognostic impact of atrial cardiomyopathy |b Long-term follow-up of patients with and without low-voltage areas following atrial fibrillation ablation |
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| 500 | |a Date Revised 01.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Atrial cardiomyopathy is known as an underlying pathophysiological factor in the majority of patients with atrial fibrillation (AF). Left atrial low-voltage areas (LVAs) are reported to coincide with fibrosis and likely represent atrial cardiomyopathy | ||
| 520 | |a OBJECTIVE: The purpose of this study was to delineate differences in the long-term prognosis of patients stratified by the size of LVAs | ||
| 520 | |a METHODS: This observational study included 1488 consecutive patients undergoing initial ablation for AF. LVAs were defined as regions with a bipolar peak-to-peak voltage <0.50 mV. The total study population was divided into 3 groups stratified by LVA size: patients with no LVAs (n = 1136); those with small (<20 cm2) LVAs (n = 250) LVAs; and those with extensive (≥20 cm2) LVAs (n = 102). Composite endpoints of death, heart failure, and stroke were followed for up to 5 years | ||
| 520 | |a RESULTS: Composite endpoints developed in 105 of 1488 patients (7.1%), and AF recurrence occurred in 410 (27.6%). Composite endpoints developed more frequently in the order of patients with extensive LVAs (19.1%), small LVAs (10.8%), and no LVAs (5.1%) (P for trend <.0001). Multivariable analysis revealed that LVA presence was independently associated with higher incidence of composite endpoints, irrespective of AF recurrence (modified hazard ratio 1.73; 95% confidence interval 1.13-2.64; P = .011) CONCLUSION: LVA presence and its extent both were associated with poor long-term composite endpoints of death, heart failure, and stroke, irrespective of AF recurrence or other confounders. Underlying atrial cardiomyopathy seems to define a poor prognosis after AF ablation | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Atrial cardiomyopathy | |
| 650 | 4 | |a Heart failure | |
| 650 | 4 | |a Low-voltage area | |
| 650 | 4 | |a Mortality | |
| 650 | 4 | |a Prognosis | |
| 650 | 4 | |a Recurrence | |
| 650 | 4 | |a Stroke | |
| 700 | 1 | |a Matsuda, Yasuhiro |e verfasserin |4 aut | |
| 700 | 1 | |a Uematsu, Hiroyuki |e verfasserin |4 aut | |
| 700 | 1 | |a Sugino, Ayako |e verfasserin |4 aut | |
| 700 | 1 | |a Ooka, Hirotaka |e verfasserin |4 aut | |
| 700 | 1 | |a Kudo, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Fujii, Subaru |e verfasserin |4 aut | |
| 700 | 1 | |a Asai, Mitsutoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Okamoto, Shin |e verfasserin |4 aut | |
| 700 | 1 | |a Ishihara, Takayuki |e verfasserin |4 aut | |
| 700 | 1 | |a Nanto, Kiyonori |e verfasserin |4 aut | |
| 700 | 1 | |a Tsujimura, Takuya |e verfasserin |4 aut | |
| 700 | 1 | |a Hata, Yosuke |e verfasserin |4 aut | |
| 700 | 1 | |a Higashino, Naoko |e verfasserin |4 aut | |
| 700 | 1 | |a Nakao, Sho |e verfasserin |4 aut | |
| 700 | 1 | |a Mano, Toshiaki |e verfasserin |4 aut | |
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