Low Voltage Area Modification in Older Patients With Atrial Fibrillation.

IF 1.7 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Pace-Pacing and Clinical Electrophysiology Pub Date : 2025-05-23 DOI:10.1111/pace.15203

Ning Chen, Zhou Xu, Hongwu Chen, Gang Yang, Lei Wang, Youmei Shen, Nan Wu, Sion Ju, Weizhu Ju, Mingfang Li, Kai Gu, Hailei Liu, Minglong Chen

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引用次数: 0

Abstract

Background: Age has been found as an important factor affecting the low voltage area (LVA) in patients with atrial fibrillation (AF). This study aims to investigate the potential benefit of LVA modification in older AF patients.

Methods: This study constitutes a sub-analysis of the STABLE-SR-II and STABLE-SR-III trials, wherein patients with persistent AF (PeAF) or paroxysmal AF (PAF) were randomized to undergo either circumferential pulmonary vein isolation (CPVI) alone or additional LVA modification. Patients aged ≥65 years were analyzed. The primary outcome was freedom from atrial tachyarrhythmias (ATAs).

Results: A total of 510 patients (mean age 70.2 ± 3.8 years, 264 male) were analyzed, comprising 96 PeAF and 414 PAF patients. Among patients without LVA, the risk of ATAs recurrence was similar between PeAF and PAF patients in the propensity score-matched model (adjusted HR, 1.49 [0.54-4.33]; p = 0.431). Both PeAF (adjusted HR, 0.35 [95% CI, 0.12-0.98]; p = 0.048) and PAF patients (adjusted HR, 0.41 [0.19-0.81]; p = 0.013) could benefit from additional LVA modification in the Cox proportional hazards model.

Conclusions: In older patients with AF, the recurrence rate following CPVI alone is comparable between those with PAF and PeAF in the absence of LVA. However, the presence of LVA is associated with higher recurrence rates in both PAF and PeAF patients, while additional LVA modification effectively reduces recurrence irrespective of AF type.

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老年心房颤动患者的低压区改造。

背景：年龄是影响心房颤动（AF）患者低压区（LVA）的重要因素。本研究旨在探讨LVA调整对老年房颤患者的潜在益处。方法：本研究是STABLE-SR-II和STABLE-SR-III试验的亚分析，其中持续性房颤（PeAF）或阵发性房颤（PAF）患者随机接受单独的环肺静脉隔离（CPVI）或额外的LVA修饰。年龄≥65岁的患者进行分析。主要终点是无房性心动过速（ATAs）。结果：共分析510例患者（平均年龄70.2±3.8岁，男性264例），其中PeAF 96例，PAF 414例。在没有LVA的患者中，PeAF和PAF患者在倾向评分匹配模型中ATAs复发的风险相似(调整后的HR为1.49 [0.54-4.33]；p = 0.431)。PeAF(校正HR， 0.35 [95% CI, 0.12-0.98]；p = 0.048)和PAF患者(调整后HR为0.41 [0.19-0.81]；p = 0.013)可以从Cox比例风险模型中额外的LVA修正中获益。结论：在老年房颤患者中，在没有LVA的情况下，单纯CPVI后的复发率与PAF和PeAF患者相当。然而，在PAF和PeAF患者中，LVA的存在与更高的复发率相关，而额外的LVA修饰可以有效地减少复发，而与AF类型无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pace-Pacing and Clinical Electrophysiology 医学-工程：生物医学

CiteScore

2.70

自引率

5.60%

发文量

209

审稿时长

2-4 weeks

期刊介绍： Pacing and Clinical Electrophysiology (PACE) is the foremost peer-reviewed journal in the field of pacing and implantable cardioversion defibrillation, publishing over 50% of all English language articles in its field, featuring original, review, and didactic papers, and case reports related to daily practice. Articles also include editorials, book reviews, Musings on humane topics relevant to medical practice, electrophysiology (EP) rounds, device rounds, and information concerning the quality of devices used in the practice of the specialty.