Abstract 19088: Atrial Late Potentials and Atrial Substrate Remodeling in Patients With Atrial Fibrillation
Backgrounds: Patients with atrial fibrillation (AF) often have a low-amplitude potential in the terminal part of filtered P-wave (atrial late potential: aLP). However, it remains unknown what aLP reflects in AF patients. On the other hand, electrical remodeling of the atria can be precisely evaluated by the quantitative voltage map analysis using 3D mapping system. In this study, we hypothesized that we could substitute "non-invasive" aLP for "invasive" 3D mapping system to evaluate the atrial electrical remodeling and investigated the relationship between aLP and atrial substrate remodeling in AF patients.
Methods: The P-wave single-averaged electrocardiogram (P-SAECG) was recored in 60 patients with paroxysmal AF who underwent PV isolation. Filtered P-wave duration (fPWD) and root-mean-squared voltage of the terminal 20ms of ≤2.0 μV (RMS20) were assessed by P-SAECG. The left atrial (LA) global contact mapping during sinus rhythm was performed and LA voltage zone index (LAVZI) was defined as an area with voltage < 0.5mV divided by total LA surface area.
Results: LAVZI showed a strong positive correlation with fPWD and a strong negative correlation with RMS20 (r=-0.82, p<0.01; r=0.68, p<0.01, respectively). LV volume by echocardiography was also positively correlated with fPWD and negatively correlated with RMS20 (r=0.57, p<0.05; r=-0.69, p<0.01, respectively). In addition, LA appendage flow was negatively correlated with fPWD (r=-0.49, p<0.05). fPWD was significantly longer and RMS20 was lower in patients with AF for more than 1 year than those for less than 1 year. However, there were no significant correlations between aLP parameters and other echocardiographic findings such as left ventricular ejection fraction or plasma BNP concentration.
Conclusions: aLP reflects precisely atrial substrate remodeling in AF patients. aLP might serve as non-invasive tool for monitoring the atrial substrate remodeling in patients with AF.
Author Disclosures: S. Bando: None. T. Soeki: None. T. Matsuura: None. T. Tobiume: None. T. Ise: None. K. Kusunose: None. K. Yamaguchi: None. S. Yagi: None. H. Yamada: None. T. Wakatsuki: None. M. Sata: None.
- © 2015 by American Heart Association, Inc.