Halim Marzak, Justine Hammann, Kensuke Matsushita, Romain Ringele, Simon Fitouchi, François Severac, Thomas Cardi, Mohamad Kanso, Alexandre Schatz, Patrick Ohlmann, Olivier Morel, Laurence Jesel
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We assessed regional distribution of left atrial (LA) bipolar voltage, the extent of low-voltage zones (LVZs), and outcomes of voltage-guided ablation in AF patients with and without TIC.</p><p><strong>Methods and results: </strong>In all, 139 patients with persistent AF presenting for a first voltage-guided catheter ablation were enrolled, 61 with TIC and 78 with structurally normal hearts. LA voltage maps were obtained using a 3-dimensional electroanatomical mapping system in sinus rhythm. LVZ was defined as <0.5 mV. Compared with non-TIC patients, TIC patients had a lower indexed LA volume (median [interquartile range] 58.6 [50.6-68.7] vs. 63.4 [60.1-76.1] mL/m<sup>2</sup>; P<0.01) and higher LA voltage (2.3 [1.5-2.8] vs. 1.7 [1-2.6] mV; P=0.02). LVZs were less frequently found in patients with than without TIC (8 [13.1%] vs. 30 [39%]; P<0.01). There was no significant difference in atrial tachyarrhythmia (AT)-free survival rate over a 36-month follow-up between the 2 groups (log-rank test, P=0.176). No predictor of AT recurrence was identified.</p><p><strong>Conclusions: </strong>TIC patients exhibit less LA substrate remodeling with a smaller LA volume, higher bipolar voltage, and fewer LVZs than non-TIC patients. 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引用次数: 0
摘要
背景:伴有心动过速诱发心肌病(TIC)的持续性心房颤动(AF)患者接受导管消融术的疗效与无 TIC 的患者相似,甚至更好。有关 TIC 病例中心房基底重塑的数据很少。我们评估了有TIC和无TIC的房颤患者左心房(LA)双极电压的区域分布、低电压区(LVZ)的范围以及电压引导消融的结果:共有 139 名首次接受电压引导导管消融术的持续性房颤患者,其中 61 人患有 TIC,78 人心脏结构正常。在窦性心律状态下,使用三维电解剖绘图系统获得 LA 电压图。LVZ定义为2;PC结论:与非 TIC 患者相比,TIC 患者的 LA 基底重塑较少,LA 容积较小,双极电压较高,LVZ 较少。与非 TIC 患者相比,TIC 患者的 LA 基底重塑较少,LA 容积较小,双极电压较高,LVZ 较少,单次手术后的良好预后相似。
Left Atrial Low-Voltage Zone Assessment and Voltage-Guided Ablation Outcome in Patients With Atrial Fibrillation-Induced Tachycardiomyopathy.
Background: Persistent atrial fibrillation (AF) patients with tachycardia-induced cardiomyopathy (TIC) undergoing catheter ablation have similar or even better outcomes than patients without TIC. Data regarding atrial substrate remodeling are scarce in cases of TIC. We assessed regional distribution of left atrial (LA) bipolar voltage, the extent of low-voltage zones (LVZs), and outcomes of voltage-guided ablation in AF patients with and without TIC.
Methods and results: In all, 139 patients with persistent AF presenting for a first voltage-guided catheter ablation were enrolled, 61 with TIC and 78 with structurally normal hearts. LA voltage maps were obtained using a 3-dimensional electroanatomical mapping system in sinus rhythm. LVZ was defined as <0.5 mV. Compared with non-TIC patients, TIC patients had a lower indexed LA volume (median [interquartile range] 58.6 [50.6-68.7] vs. 63.4 [60.1-76.1] mL/m2; P<0.01) and higher LA voltage (2.3 [1.5-2.8] vs. 1.7 [1-2.6] mV; P=0.02). LVZs were less frequently found in patients with than without TIC (8 [13.1%] vs. 30 [39%]; P<0.01). There was no significant difference in atrial tachyarrhythmia (AT)-free survival rate over a 36-month follow-up between the 2 groups (log-rank test, P=0.176). No predictor of AT recurrence was identified.
Conclusions: TIC patients exhibit less LA substrate remodeling with a smaller LA volume, higher bipolar voltage, and fewer LVZs than non-TIC patients. They have a similar favorable outcome after a single procedure.
期刊介绍:
Circulation publishes original research manuscripts, review articles, and other content related to cardiovascular health and disease, including observational studies, clinical trials, epidemiology, health services and outcomes studies, and advances in basic and translational research.