Arrhythmias & electrophysiology
Unipolar-voltage-based evaluation of left atrial tissue properties and ablation outcome in patients with atrial fibrillation
Authors' conclusion
Combining UV and LAWT enables us to stratify recurrence risk and suggest a tailored ablation strategy according to LA tissue properties.
Study context
- Population
- Atrial fibrillation (AF) patients undergoing AF ablation; Pulmonary vein (PV)-ostial unipolar voltage (UV) by CARTO and left atrial wall thickness (LAWT) by CT
- Participants
- 272 patients
- Exposure
- Atrial tachyarrhythmia (ATA) recurrence vs no recurrence; LA hypertrophy phenotypes
- ATA-Recn = 74
- LAH-HUVn = 66
- LAH-LUVn = 26
- Outcome
- Atrial tachyarrhythmia (ATA) recurrence including AF
Main finding
As reported in the abstract
ATA recurrence
ATA-Rec
74
events
P < 0.001
- Cut-off values for ATA recurrence: UV 2.7 mV and corresponding LAWT 1.6 mm
- P < 0.001
Observational data: associations, not effects.
Further findings
Correlation of UV with LAWT
- Strong positive correlation, R2 = 0.446
- P < 0.001
Ablation outcome by LA hypertrophy (LAH) phenotype
- LAH-LUV worst ablation outcome, followed by LAH-HUV and No LAH
- log-rank P < 0.001
- LAH-LUV characterized by history of non-paroxysmal AF and HF, reduced LVEF, or enlarged LA
Original publication
Unipolar-voltage-based evaluation of left atrial tissue properties and ablation outcome in patients with atrial fibrillation. Europace. Published 4 August 2023. doi:10.
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