Arrhythmias & electrophysiologyCohort study
Left atrial myopathy development and progression in atrial fibrillation patients with recurrent left atrial ablation procedures: The LAMP-AF study
- Consecutive adults undergoing de novo left atrial (LA) ablation for atrial fibrillation (AF) were enrolled, with repeat ablation cases analyzed
- longitudinal
Authors' conclusion
LA myopathy advances in one-third of repeat AF ablation patients without chamber enlargement, exhibiting heterogeneous progression favoring septal, anterior, and posterior segments while sparing the lateral wall. Baseline CV and LA volume robustly predict LVA progression, indicating functional electrical remodeling precedes structural fibrosis, highlighting the importance of integrating functional markers when characterizing atrial substrate progression.
Study context
- Population
- Adults undergoing de novo left atrial ablation for AF who had repeat ablation
- Participants
- 90 repeat ablation patients
- Exposure
- progression vs no progression
Main finding
As reported in the abstract
total LVA increased from
9.5 ± 16.8% to 19.0 ± 24.7%
P
P < .001
Observational data: associations, not effects.
Further findings
| Outcome | progression | no progression | Estimate | P value |
|---|---|---|---|---|
| Baseline characteristics by progression | ||||
| CHA2DS2-VASc | 2.75 | 2.05 | ||
| LA volume | 152 mL | 122 mL | ||
| baseline CV | 0.86 m/s | 1.02 m/s | ||
| 12-month AF recurrence predicted by LVA burden — LVA burden (baseline) · baseline | odds ratio 3.65 per 1% | P = 0.049 | ||
| 12-month AF recurrence predicted by LVA burden — LVA burden (second procedure) · at second procedure | odds ratio 2.54 | P = 0.012 |
- Baseline characteristics by progression: CHA2DS2-VASc P = .021
- Baseline characteristics by progression: LA volume P = .008
- Baseline characteristics by progression: Conduction velocity (CV) P = .013
Patients with >10% LVA progression
- patients with >10% progression
- 33%
- septal
- 42%
- anterior
- 37%
- posterior
- 34%
Multivariable predictors of progression
- baseline LA volume
- P = 0.002
- CV
- P = 0.043
- R2
- 0.206
Original publication
Summarised from the published abstract; every number is checked against it