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Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
Published on: July 20, 2022
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Left atrial remodeling: Regional differences between paroxysmal and persistent atrial fibrillation
Rikitake Kogawa1, Yasuo Okumura1, Ichiro Watanabe1
1Division of Cardiology, Department of Medicine, Nihon University School of Medicine, 30-1, Oyaguchi-kamimachi, itabashi-ku, Tokyo 173-8610, Japan.
Journal of Arrhythmia
|October 13, 2017
Summary
Persistent atrial fibrillation (AF) shows lower left atrial (LA) voltages compared to paroxysmal AF (PAF). This suggests distinct electrical remodeling patterns in persistent AF, potentially originating from the right pulmonary veins and LA walls.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Research
Background:
- Mechanisms of persistent atrial fibrillation (AF) self-perpetuation remain unclear.
- Comparing left atrial (LA) electroanatomic maps in paroxysmal AF (PAF) and persistent AF (PerAF) offers insight.
- LA voltage mapping during sinus rhythm is a key diagnostic tool.
Purpose of the Study:
- To investigate differences in LA electroanatomic characteristics between patients with PAF and PerAF.
- To identify specific regions of voltage abnormalities in persistent AF.
- To elucidate the structural remodeling patterns contributing to AF persistence.
Main Methods:
- Included 23 men with PAF and 13 men with PerAF.
- Performed LA bipolar voltage mapping during sinus rhythm.
- Statistically analyzed clinical and electroanatomic data.
Main Results:
- Significantly lower bipolar voltages observed in PerAF patients compared to PAF patients.
- Affected regions include LA septum, roof, posterior wall, and right pulmonary vein (PV) areas (antrum, carina).
- No significant voltage differences in other LA regions.
Conclusions:
- Distinct regional voltage differences characterize PAF and PerAF.
- LA structural remodeling in PerAF may originate from right PVs, their antra, and specific LA walls.
- Findings contribute to understanding AF pathophysiology and potential therapeutic targets.
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