Biatrial Substrate Properties in Patients with Atrial Fibrillation

Abstract

The LA voltage was lower than the RA, and the atrial voltage correlated with the TAT. Electroanatomical remodeling of the atria could be crucial to the maintenance of AF. The LA substrate properties may play an important role in the recurrence of AF after catheter ablation of AF.

Impact of Atrial Remodeling on the Outcome of Radiofrequency Catheter Ablation of Paroxysmal Atrial Fibrillation

“…1,2 A large extent of the atrial arrhythmic substrate is associated with the limited efficacy of radiofrequency catheter ablation (RFCA) of AF. 3- 5 The size of the left atrium (LA) is related to structural remodeling and has been identified as an independent predictor of AF recurrence after RFCA. 6-8 The total atrial conduction time reflects not only structural but also electrical atrial remodeling.…”

The Impact of Diastolic Dysfunction on the Atrial Substrate Properties and Outcome of Catheter Ablation in Patients With Paroxysmal Atrial Fibrillation

“…8, 9 In brief, each patient underwent an electrophysiological study and catheter ablation in a fasting, non-sedated state after written informed consent was obtained. After completing an intact right atrial (RA) and LA geometry reconstruction using the NavX mapping system, a sequential contact voltage map was constructed in all patients during sinus rhythm before the radiofrequency (RF) ablation.…”

Three-Dimensional Electroanatomic Mapping Systems in Catheter Ablation of Atrial Fibrillation

“…Chang et al also demonstrated a worsening of the atrial voltage, as well as prolongation of the atrial activation time, as the AF progressed from paroxysmal to chronic. 13 There is a good correlation between the decrement in LA voltage and prolongation of the atrial activation time. Lo et al also found progressive remodeling of the atrial substrate in patients with recurrent AF (Figure 1).…”

“…14 Much evidence for identifying the substrate properties has been provided by both contact and noncontact mapping systems. [13][14][15][16][17][18][19][20][21][22] Using the contact mapping system, it was reported by Sanders et al that slowing of atrial regional conduction with a greater number of electrograms with fractionation and areas of low voltage occurred in patients with congestive heart failure and sinus node disease. 14, 16 Verma et al reported that the preexistence of a LA scar in patients undergoing PV isolation was a powerful, independent predictor of a procedural failure.…”

“…12,13 The double potentials represent conduction block, whereas fractionated potentials indicate slow conduction. Most importantly, the result of voltage mapping from the electroanatomic mapping system is a guide to the severity of the atrial cardiomyopathy.…”