title: Left atrial voltage during atrial fibrillation in paroxysmal and persistent atrial fibrillation patients.
abstract: BACKGROUND
  Left atrial (LA) endocardial voltage characteristics assessed during atrial fibrillation (AF) have not been previously compared in different AF types. This study was aimed at investigating the LA voltages and volumes in patients with paroxysmal and persistent AF.
  
  
  METHODS
  LA electroanatomic voltage maps acquired during AF were compared between consecutive patients without major structural heart disease undergoing first catheter ablation for paroxysmal AF (n = 100) or persistent AF (n = 100). The groups were comparable in baseline clinical characteristics.
  
  
  RESULTS
  Patients with persistent AF presented with lower median LA voltage (median 0.41, interquartile range [IQR] 0.31-0.51 mV versus median 0.99, IQR 0.47-1.56 mV; P < 0.001), and maximum LA voltage (4.07 +/- 1.76 vs 6.42 +/- 2.16 mV; P < 0.001). They also had a higher proportion of the LA points exhibiting voltage <0.2 mV (30 +/- 20 vs 12 +/- 11%; P < 0.001) and voltage 0.2-1.0 mV (55 +/- 15 vs 42 +/- 19%; P < 0.001). They further displayed higher LA volume/body surface area (75 +/- 16 vs 58 +/- 13 mL/m(2); P < 0.001). In the multivariate regression model, both LA voltage (P < 10(-9)) and LA volume (P < 10(-5)) were significant determinants of AF type.
  
  
  CONCLUSIONS
  Patients with persistent AF had significantly lower LA voltage compared with patients with paroxysmal AF even after adjustment for differences in indexed LA volume. LA voltage represents an independent covariate of clinical manifestation of AF.
authors.affiliation: Department of Cardiology, Heart Centre, Hospital Podlesí a.s., Trinec, Czech Republic. martin.fiala@gmail.com
authors.forename: Martin
authors.initials: M
authors.lastname: Fiala
authors.forename: Dan
authors.initials: D
authors.lastname: Wichterle
authors.forename: Jan
authors.initials: J
authors.lastname: Chovancík
authors.forename: Veronika
authors.initials: V
authors.lastname: Bulková
authors.forename: Dorota
authors.initials: D
authors.lastname: Wojnarová
authors.forename: Renáta
authors.initials: R
authors.lastname: Nevralová
authors.forename: Jaroslav
authors.initials: J
authors.lastname: Januska
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology* / Q000601:surgery; D018780:Body Surface Potential Mapping; D017115:Catheter Ablation; D055724:Electrophysiological Phenomena; D005260:Female; D006325:Heart Atria / Q000503:physiopathology* / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D016896:Treatment Outcome; D055815:Young Adult