Slow left atrial conduction velocity in the anterior wall calculated by electroanatomic mapping predicts atrial fibrillation recurrence after catheter ablation—Systematic review and meta-analysis

IF 2.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Arrhythmia Pub Date : 2024-09-05 DOI:10.1002/joa3.13146

Antonia Anna Lukito MD, PhD, Wilson Matthew Raffaello MD, Raymond Pranata MD

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Abstract

Background

This study aimed to investigate and perform diagnostic test meta-analysis on whether slow left atrial conduction velocity (LACV) in the anterior wall calculated by electroanatomic mapping predicts atrial fibrillation (AF) recurrence after catheter ablation.

Methods

Extensive literature search was performed on PubMed, SCOPUS, and EuropePMC up to June 5, 2024. The exposure group included AF patients with slow LACV in the anterior wall, while the control group included AF patients without slow LACV in the anterior wall. Slow LACV in the anterior wall was defined as LACV below study-specific cut-off points in m/s, measured by invasive electroanatomic mapping. The primary outcome of this study was AF recurrence, defined as AF/Atrial Flutter/Atrial Tachyarrhythmias lasting over 30 s at least 3 months after the blanking period postablation.

Results

This systematic review and meta-analysis included seven studies, involving a sample size of 1428 patients with mean follow-up duration were 13 months. Patients with AF recurrence has slower LACV in the anterior wall (mean difference − 0.16 m/s [−0.18, −0.15], p < .001). Slow LACV in the anterior wall defined as LACV below 0.70–0.88 m/s was associated with increased AF (adjusted OR 3.41 [1.55, 7.50], p = .002). Slow LACV in the anterior wall has an AUROC of 0.80 [0.76–0.83], sensitivity of 70% [52, 84], specificity of 76% [67, 83], positive likelihood ratio of 2.9 [2.3, 3.6], negative likelihood ratio of 0.39 [0.25, 0.63] for predicting AF recurrence postablation.

Conclusion

Slow LACV in the anterior wall was associated with AF recurrence after catheter ablation.

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通过电解剖图计算的前壁左心房缓慢传导速度可预测导管消融术后心房颤动复发--系统回顾和荟萃分析

背景本研究旨在调查通过电解剖图计算出的前壁左心房缓慢传导速度（LACV）是否能预测导管消融术后心房颤动（AF）复发，并进行诊断测试荟萃分析。方法截至 2024 年 6 月 5 日，在 PubMed、SCOPUS 和 EuropePMC 上进行了广泛的文献检索。暴露组包括前壁慢速 LACV 的房颤患者，对照组包括前壁无慢速 LACV 的房颤患者。前壁慢速 LACV 的定义是通过有创电解剖图测量的 LACV 低于研究特定的临界点（单位：m/s）。本研究的主要结果是房颤复发，定义为消融术后空白期至少 3 个月后房颤/房扑/房性快速性心律失常持续时间超过 30 秒。结果本次系统回顾和荟萃分析共纳入 7 项研究，样本量为 1428 例患者，平均随访时间为 13 个月。房颤复发患者的前壁 LACV 较慢（平均差异 - 0.16 m/s [-0.18, -0.15]，p < .001）。定义为 LACV 低于 0.70-0.88 m/s 的前壁 LACV 缓慢与房颤增加有关（调整 OR 3.41 [1.55, 7.50]，p = .002）。前壁缓慢 LACV 的 AUROC 为 0.80 [0.76-0.83]，敏感性为 70% [52，84]，特异性为 76% [67，83]，预测消融术后房颤复发的阳性似然比为 2.9 [2.3，3.6]，阴性似然比为 0.39 [0.25，0.63]。结论前壁缓慢的 LACV 与导管消融后房颤复发有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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