Different Patterns of Atrial Remodeling After Catheter Ablation of Chronic Atrial Fibrillation

• Published in: Journal of cardiovascular electrophysiology 2011-04, Vol.22 (4), p.385-393
• Main Authors: LO, LI-WEI, TSAO, HSUAN-MING, LIN, YENN-JIANG, CHANG, SHIH-LIN, HU, YU-FENG, TSAI, WEN-CHIN, TUAN, TA-CHUN, SUENARI, KAZUYOSHI, HUANG, SHIH-YU, TUNG, NGUYEN-HUU, HIGA, SATOSHI, TAI, CHING-TAI, UENG, KWO-CHANG, LI, CHENG-HUNG, CHAO, TZE-FAN, WU, TSU-JUEY, CHEN, SHIH-ANN
• Format: Article
• Language: English
• Subjects: atrial fibrillation; Atrial Fibrillation - physiopathology; Atrial Fibrillation - surgery; Atrial Function, Left - physiology; Body Surface Potential Mapping - methods; catheter ablation; Catheter Ablation - methods; Chronic Disease; computed tomography; Female; Follow-Up Studies; Humans; Male; mapping; Middle Aged; remodeling
• ISSN: 1045-3873; 1540-8167
• DOI: 10.1111/j.1540-8167.2010.01927.x

Atrial Substrate Remodeling After Chronic AF Ablation. Background: Multiple remodeling patterns have been observed after catheter ablation of atrial fibrillation (AF). Objective: We aimed to clarify the electrical/structural properties associated with recurrences after ablation of chronic AF. Methods: After a stepwise ablation procedure in 120 consecutive patients with persistent/long‐lasting persistent AF, 36 had a recurrence of AF (Group 1/Group 2: recurrence with paroxysmal/persistent AF, n = 16/20). Results: During the first procedure, the left atrial (LA) bipolar voltage did not differ between the 2 groups, and the LA volume was smaller in Group 1 than in Group 2 and it was the only factor predicting the recurrent types (P = 0.009, OR = 1.04). In the second procedure, the bipolar voltage of the global left atrium increased (1.33 ± 0.11 mV vs 1.76 ± 0.16 mV, P = 0.001) in Group 1 and decreased (1.31 ± 0.14 mV vs 0.90 ± 0.12 mV, P = 0.01) in Group 2, when compared with that of the first procedure. The LA low‐voltage area (