Progressive remodeling of the atrial substrate--a novel finding from consecutive voltage mapping in patients with recurrence of atrial fibrillation after catheter ablation.
BACKGROUND
Atrial substrate properties have been demonstrated to be related to atrial arrhythmias. This study investigated whether the atrial substrate exhibits progressive remodeling in patients with recurrence of atrial fibrillation (AF) after catheter ablation.


RESULTS
Fifteen consecutive AF patients (52 +/- 12 years old, 12 males) underwent the same mapping technique (NavX, St. Jude Medical, Minnetonka, MN, USA) and same ablation technique for primary AF and recurrence of AF (170 +/- 66 days after the first procedure). The bipolar mean peak-to-peak voltage (PPV) of the global left atrium during sinus rhythm significantly decreased in the second procedure (2.25 +/- 0.62 vs. 1.79 +/- 0.60 mV, P = 0.008). Also, the percentage of the surface area of the low voltage zone (LVZ; less than 0.5 mV) in the left atrium increased from 6 +/- 4% to 13 +/- 6% (P = 0.001) in the second procedure. There was no significant change in the right atrial bipolar mean PPV or surface area of the LVZ in the second procedure.


CONCLUSIONS
Atrial substrate remodeling with a progressive decrease in the left atrial voltage was demonstrated in patients with recurrent AF.
Lo
Li-Wei
LW
Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Tai
Ching-Tai
CT
Lin
Yenn-Jiang
YJ
Chang
Shih-Lin
SL
Wongcharoen
Wanwarang
W
Chang
Sheng-Hsiung
SH
Hsieh
Ming-Hsiung
MH
Tuan
Ta-Chuan
TC
Udyavar
Ameya R
AR
Chen
Yi-Jen
YJ
Tsao
Hsuan-Ming
HM
Chen
Shih-Ann
SA
D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000601:surgery*; D018780:Body Surface Potential Mapping; D017115:Catheter Ablation; D022062:Electrophysiologic Techniques, Cardiac / Q000379:methods; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation