title: Progressive remodeling of the atrial substrate--a novel finding from consecutive voltage mapping in patients with recurrence of atrial fibrillation after catheter ablation.
abstract: 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.
authors.affiliation: Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors.forename: Li-Wei
authors.initials: LW
authors.lastname: Lo
authors.forename: Ching-Tai
authors.initials: CT
authors.lastname: Tai
authors.forename: Yenn-Jiang
authors.initials: YJ
authors.lastname: Lin
authors.forename: Shih-Lin
authors.initials: SL
authors.lastname: Chang
authors.forename: Wanwarang
authors.initials: W
authors.lastname: Wongcharoen
authors.forename: Sheng-Hsiung
authors.initials: SH
authors.lastname: Chang
authors.forename: Ming-Hsiung
authors.initials: MH
authors.lastname: Hsieh
authors.forename: Ta-Chuan
authors.initials: TC
authors.lastname: Tuan
authors.forename: Ameya R
authors.initials: AR
authors.lastname: Udyavar
authors.forename: Yi-Jen
authors.initials: YJ
authors.lastname: Chen
authors.forename: Hsuan-Ming
authors.initials: HM
authors.lastname: Tsao
authors.forename: Shih-Ann
authors.initials: SA
authors.lastname: Chen
mesh_terms: 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