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Comparison and significance of atrial low voltage areas among patients with atrial fibrillation in different rhythms |
ZHANG Wenjing, WANG Hao, DING Aolin, YANG Jingwei, GU Yunfei |
[1. Department of Cardiovascular Medicine, Luoyang Central Hospital Affiliated to Zhengzhou University, Luoyang Zhengzhou 471000; 2. Johnson & Johnson (Shanghai) Medical Equipment Co., Ltd, Shanghai 200052, China] |
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Abstract Objective To investigate the characteristics and significance of atrial low voltage areas(LVAs) measured by electroanatomical mapping among patients with atrial fibrillation(AF) in different rhythms, and to analyze the effect of pure pulmonary vein isolation (PVI) on LVAs. Methods Eighty-four patients (49 with paroxysmal AF and 35 with persistent AF) who had undergone radial frequency ablation for the first time were consecutively enrolled and matched using propensity scoring. The areas of LVAs in each region after the atrial quintile were measured and analyzed at a threshold of 0.5 mV. Results Thirty-one groups of patients are matched by using propensity scoring according to age, sex and BMI. The mean number of mapping points before and after the ablation are separately 1 434.2±393.6 and 1 281.3±372.7 in patients with paroxysmal AF while the numbers are 1 652.6±728.2 and 1 314.6±690.8 respectively in patients with persistent AF. LVAs could be recorded in all research subjects. There is no significant difference in LVAs preoperatively and postoperatively in patients with paroxysmal AF; the area of LVAs is significantly decreased postoperatively in patients with persistent AF (P<0.05). Among all the 84 AF patients, the proportions of LVAs presented in the anterior wall, septem, inferior wall, lateral wall, and posterior wall are 69.0%, 95.2%, 82.1%, 60.7% and 52.4%, respectively. Conclusion At the same voltage threshold, the area of LVAs in patients with persistent AF is significantly larger in AF rhythm than that in sinus rhythm, and pure PVI has little effect on LVAs. LVAs are prevalent in the anterior wall, septem and inferior wall in AF patients.
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