Association between left atrial slow conduction velocity and recurrence of atrial fibrillation: a prospective study based on high-density mapping.

IF 2.6 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Interventional Cardiac Electrophysiology Pub Date : 2025-04-30 DOI:10.1007/s10840-025-02052-5

Dan Qi, Xiaonan Guan, Xiaoqing Liu, Lifeng Liu, Zheng Liu, Jianjun Zhang

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引用次数: 0

Abstract

Background: The level of atrial remodeling is closely related to the recurrence of atrial fibrillation (AF). Although structural remodeling has been extensively evaluated, methods for assessing atrial electrical remodeling have not been established. The purpose of our study is to investigate the relationship between atrial conduction velocity and the recurrence of atrial fibrillation (AF) following radiofrequency ablation with pulmonary vein isolation.

Methods and results: We prospectively enrolled 155 patients with paroxysmal atrial fibrillation who underwent their first AF ablation at our center. High-density bipolar voltage mapping was conducted during sinus rhythm in all patients. A coherent mapping was constructed to accurately evaluate the total conduction time, distance, and left atrial conduction velocity (LACV) on the anterior, posterior, and septal routes between the earliest and latest activation sites during sinus rhythm. Out of the patients, 24 experienced a recurrence of AF. The LACV was significantly lower in the patients with AF recurrence compared to those without (anterior, 0.81 ± 0.03 vs. 1.07 ± 0.02 m/s, p < 0.01; posterior, 1.06 ± 0.05 vs. 1.32 ± 0.03 m/s, p < 0.01; septal, 0.91 ± 0.05 vs. 1.13 ± 0.02 m/s, p < 0.01). A multivariate logistic analysis, which included age, left atrial diameter (LAD), LA low-voltage area, P-wave duration, and LA conduction velocity, demonstrated that a slow anterior left atrial conduction velocity (LACV) was an independent predictor of AF recurrence with an adjusted odds ratio of 1.64 (95% confidence interval [CI]: 1.24-3.78, p < 0.01). ROC curve analysis confirmed that the anterior LACV was the most accurate predictor of AF recurrence after pulmonary vein isolation (PVI) with a cut-off value of 0.83 m/s, a sensitivity of 93.9%, and a specificity of 70.8%. Anterior LACV was lower in patients with low-voltage areas than in those without low-voltage areas (0.81 ± 0.03 vs. 1.09 ± 0.02 cm/s, p < 0.01).

Conclusion: An anterior LACV < 0.83 m/s was identified as a strong independent predictor of AF recurrence after PVI in patients with paroxysmal AF.

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左房慢传导速度与房颤复发的关系：一项基于高密度测绘的前瞻性研究。

背景：心房重构水平与心房颤动（AF）的复发密切相关。虽然结构重构已被广泛评估，但评估心房电重构的方法尚未建立。本研究的目的是探讨射频消融肺静脉隔离后心房颤动（AF）复发与心房传导速度的关系。方法和结果：我们前瞻性地纳入155例阵发性心房颤动患者，这些患者在我们中心接受了首次房颤消融。所有患者均在窦性心律期间进行高密度双极电压测绘。构建相干映射以准确评估窦性心律中最早和最晚激活位点之间的前、后、间隔路线上的总传导时间、距离和左房传导速度（LACV）。24例患者发生房颤复发。房颤复发患者的LACV明显低于无房颤复发患者（前路，0.81±0.03 vs 1.07±0.02 m/s, p）

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来源期刊

Journal of Interventional Cardiac Electrophysiology 医学-心血管系统

CiteScore

4.30

自引率

11.10%

发文量

320

审稿时长

4-8 weeks

期刊介绍： The Journal of Interventional Cardiac Electrophysiology is an international publication devoted to fostering research in and development of interventional techniques and therapies for the management of cardiac arrhythmias. It is designed primarily to present original research studies and scholarly scientific reviews of basic and applied science and clinical research in this field. The Journal will adopt a multidisciplinary approach to link physical, experimental, and clinical sciences as applied to the development of and practice in interventional electrophysiology. The Journal will examine techniques ranging from molecular, chemical and pharmacologic therapies to device and ablation technology. Accordingly, original research in clinical, epidemiologic and basic science arenas will be considered for publication. Applied engineering or physical science studies pertaining to interventional electrophysiology will be encouraged. The Journal is committed to providing comprehensive and detailed treatment of major interventional therapies and innovative techniques in a structured and clinically relevant manner. It is directed at clinical practitioners and investigators in the rapidly growing field of interventional electrophysiology. The editorial staff and board reflect this bias and include noted international experts in this area with a wealth of expertise in basic and clinical investigation. Peer review of all submissions, conflict of interest guidelines and periodic editorial board review of all Journal policies have been established.