Arrhythmias & electrophysiology
Atrial amyloidosis identified by biopsy in atrial fibrillation: prevalence and clinical presentation
Authors' conclusion
Atrial biopsy revealed amyloid deposits in 7% of patients undergoing AF ablation, identifying early-stage CA.
Study context
- Population
- Patients with non-valvular atrial fibrillation (AF) undergoing AF ablationRight ventricular (RV) biopsy in 385
- Participants
- 578 patients
- Exposure
- Atrial biopsy-detected cardiac amyloidosis (CA) vs non-CA vs clinical CA
- abio-CAn = 40
- Clinical CAn = 58
- Outcome
- Prevalence of cardiac amyloidosis (CA) by atrial biopsy
Main finding
As reported in the abstract
Prevalence of amyloid deposits on atrial biopsy
Amyloid deposits in atrial samples
40 patients
7%
ATTR type among atrial amyloid deposits
25
Prevalence with advancing age, left ventricular (LV) hypertrophy and left atrial low-voltage areas
20%-40%
Observational data: associations, not effects.
Further findings
| Outcome | abio-CA | non-CA | Clinical CA | P value |
|---|---|---|---|---|
| LV posterior wall thickness, abio-CA vs clinical CAThinner in abio-CA | 11.3 (SD 2.2) mm | — not stated in the abstract | 15.3 (SD 4.6) mm | P < 0.001 |
| LV posterior wall thickness, abio-CA vs non-CAThicker in abio-CA | 11.3 (SD 2.2) mm | 9.6 (SD 1.4) mm | — not stated in the abstract | P < 0.001 |
| Low-voltage areas (<0.5 mV), abio-CA vs non-CA | 45% | 13% | — not stated in the abstract | P < 0.001 |
— not stated in the abstract
Amyloid deposits on RV biopsy
- Amyloid deposits in RV samples (11 ATTR, 2 light-chain)
- 13 patients (3%)
- abio-CA with RV biopsy without RV amyloid (confined atrial amyloidosis)
- 13 of 26
Original publication
Atrial amyloidosis identified by biopsy in atrial fibrillation: prevalence and clinical presentation. Eur Heart J. Published 20 May 2025. doi:10.
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