Arrhythmias & electrophysiologyMechanistic study
Histological validation of atrial structural remodelling in patients with atrial fibrillation
- Mechanistic study
Authors' conclusion
Histological correlates of atrial structural remodelling were fibrosis, increased intercellular space, myofibrillar loss, and decreased nuclear density.
Study context
- Population
- Patients undergoing AF ablation and endomyocardial atrial biopsy
- Participants
- 230 patients
Main finding
As reported in the abstract
Histological factors associated with electroanatomic characteristics (multiple linear regression)
- Fibrosis associated with Vbiopsy
- P = .014
- Intercellular space associated with Vbiopsy
- P < .001
- Myofibrillar loss associated with Vbiopsy
- P < .001
- Myocardial nuclear density associated with Vbiopsy
- P = .002
- Fibrosis associated with VGLA
- P = .010
- Intercellular space associated with VGLA
- P < .001
- Myofibrillar loss associated with VGLA
- P = .001
- Myocardial nuclear density associated with VGLA
- P < .001
- Intercellular space associated with %Fractionated EGM
- P = .001
- Fibrosis associated with SCZtotal
- P = .028
- Intercellular space associated with SCZtotal
- P < .001
- Myofibrillar loss associated with SCZtotal
- P = .015
Further findings
Electron microscopy (33 patients) and immunohistochemistry (60 patients)
- Plasma components and immature collagen fibrils in increased intercellular space; myofilament lysis in cardiomyocytes, depending on myofibrillar loss
- Severity of myofibrillar loss associated with increased macrophage infiltration
Original publication
Histological validation of atrial structural remodelling in patients with atrial fibrillation. Eur Heart J. Published 23 June 2023. doi:10.1093/eurheartj/ehad396
Summarised from the published abstract; every number is checked against it