Prognostic value of low-voltage area burden in atrial fibrillation

The EHRA/HRS/APHRS/SOLAECE Expert Consensus on Atrial Cardiomyopathies published in 2017 defined atrial cardiomyopathy as “any complex of structural, architectural, contractile, or electrophysiological changes affecting the atria.” 1 Goette A. Kalman J.M. Aguinaga L. et al. EHRA/HRS/APHRS/SOLAECE expert consensus on atrial cardiomyopathies. Heart Rhythm. 2017; 14: e3-e40 Google Scholar Regardless of its etiology, atrial cardiomyopathy has the potential to produce clinically relevant manifestations including atrial arrhythmia as well as negative effects on atrial function – atrial contribution to ventricular filling, volume reservoir function, atrial conduction system and the secretion of natriuretic peptides. 2 Hoit B.D. Left atrial size and function:role in prognosis. J Am Coll Cardiol. 2014; 63: 493-505 Google Scholar Cardiac and non-cardiac conditions such as hypertension, heart failure, diabetes, and age-related atrial remodeling are known to promote atrial cardiomyopathy. 3 Andrade J. Khairy P. Dobrev D. Nattel S. The clinical profile and pathophysiology of atrial fibrillation. Circulation Res. 2014; 114: 1453-1468 Google Scholar Prognostic impact of atrial cardiomyopathy: Long-term follow-up of patients with and without low-voltage areas following atrial fibrillation ablationHeart RhythmPreviewAtrial cardiomyopathy is known as an underlying pathophysiological factor in the majority of patients with atrial fibrillation (AF). Left atrial low-voltage areas (LVAs) are reported to coincide with fibrosis and likely represent atrial cardiomyopathy. Full-Text PDF Open Access