Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Mapping & Imaging D-PO04 - Poster Session IV (ID 15) Poster

D-PO04-169 - Left Atrial Function Predicts The Presence Of Low Voltage Zone In Patients Undergoing Paroxysmal Atrial Fibrillation Ablation (ID 1219)


Background: Preoperative left atrial (LA) function is associated with atrial fibrillation (AF) ablation outcome. The presence of LA low voltage zone (LVZ) is also associated with recurrence after AF ablation. We hypothesized that impaired LA function reflects the presence of LVZ.
Objective: We investigated the association between baseline LA function and the presence of LVZ in patients undergoing initial PAF ablation.
Methods: Consecutive 305 patients who underwent initial PAF ablation and LA voltage mapping from January, 2017 to October, 2019 in our institute were retrospectively analyzed. We performed 256-slice MDCT at baseline. As the representative of LA function, we assessed LA emptying fraction (LAEF). LAEF was defined as {[(LAVmax) - (LAVmin)]/(LAVmax)} x 100. LVZ was defined as regions where bipolar peak-to-peak voltage was <0.05mV. We assessed the association between LAEF and the presence of LVZ by multivariate analysis. Then, we performed receiver operating characteristic (ROC) analysis for the prediction of LVZ.
Results: Out of 305 pts, 56 pts (18%) had LVZ in LA. In univariate analysis, patients with LVZ showed lower body mass index (22.9±2.8 vs. 24.1±3.8, with vs. without, P=0.029), higher percentage of female gender (52% vs. 26%, P=0.0002), higher age (72±9 vs. 61±12, P<0.0001), higher E/e’ (13.3±5.9 vs. 9.7±3.6, P<0.0001), larger maximum LA volume (87.1±25.5 mL vs. 101.9±32.3 mL) and lower LAEF (29.3±11.8% vs. 41.2±9.7, P<0.0001). In multivariate logistic regression analysis, LAEF revealed the strongest predictor for LVZ (Odds ratio: 0.94, 95%CI: 0.91-0.98, P=0.0016). High age and female gender also remained as the independent predictors. In ROC analysis, LAEF had moderate predictive accuracy for the prediction of LVZ. (AUC curve: 0.772, P<0.0001).
Conclusion: In PAF patients, preoperative LAEF was strongly associated with the presence of LVZ. LVZ might reflect regional LA dysfunction.