Influence of Left Atrium Anatomical Contact Area in Persistent Atrial Fibrillation

The influence of the external structures in atrial fibrillation patients: Relationship to focal low voltage areas in the left atrium

“…The existence of stretch-activated ion channels (SACS) has been documented in cardiac cells and these SACS are reported to explain the observations of the electrophysiological changes, such as the changes in the action potential duration (APD) [15]. In the human heart, atrial dilatation and stretch suggest a predisposition to AF by the relationship to the LA pressure and the changes in the dominant frequency values [20,23]. Pak H.N.…”

Uncontrolled blood pressure affects atrial remodeling and adverse clinical outcome in paroxysmal atrial fibrillation

“…The anterior RSPV wall is located close to the SVC, posterior LIPV to the descending aorta, and anterior superior LA to the ascending aorta. These contact regions have been reported to be strongly associated with a low‐voltage area and a fragmentation potential area . These anatomical structures act as an obstacle that might promote the fibrotic change of the LA wall.…”

Multiple focal and macroreentrant left atrial tachycardias originating from a spontaneous scar at the contiguous aorta-left atrium area in a patient with hypertrophic cardiomyopathy: a case report

“…However, a spontaneous scar can arise in the LA and can act as an arrhythmia substrate [11]. The most common region for a spontaneous scar to develop is the aorta-LA contiguous area; in this region, rigid contact between the aorta and LA exits, which can promote fibrosis and lead to scar formation [12, 13]. Hori Y. et al demonstrated 68% of the LA very low voltage area (<0.2 mV) overlapped with areas of the LA that contact external anatomical structures, such as the aorta and vertebra, suggesting that contact with external anatomical structures may influence scar formation [13].…”

“…The most common region for a spontaneous scar to develop is the aorta-LA contiguous area; in this region, rigid contact between the aorta and LA exits, which can promote fibrosis and lead to scar formation [12, 13]. Hori Y. et al demonstrated 68% of the LA very low voltage area (<0.2 mV) overlapped with areas of the LA that contact external anatomical structures, such as the aorta and vertebra, suggesting that contact with external anatomical structures may influence scar formation [13]. Wakabayashi Y. et al reported a patient with HCM who had a spontaneous scar in the LA anterior wall in contact with the right pulmonary artery, implying that HCM-induced pressure overload might contribute to remodeling and fibrosis [6].…”