Journal of Arrhythmia (Oct 2017)

Left atrial remodeling: Regional differences between paroxysmal and persistent atrial fibrillation

  • Rikitake Kogawa, MD,
  • Yasuo Okumura, MD,
  • Ichiro Watanabe, MD,
  • Koichi Nagashima, MD,
  • Keiko Takahashi, MD,
  • Kazuki Iso, MD,
  • Ryuta Watanabe, MD,
  • Masaru Arai, MD,
  • Sayaka Kurokawa, MD,
  • Kimie Ohkubo, MD,
  • Toshiko Nakai, MD,
  • Atsushi Hirayama, MD,
  • Kazumasa Sonoda, MD,
  • Toshimasa Tosaka, MD

DOI
https://doi.org/10.1016/j.joa.2017.06.001
Journal volume & issue
Vol. 33, no. 5
pp. 483 – 487

Abstract

Read online

Background: The mechanisms underlying self-perpetuation of persistent atrial fibrillation (AF) are not well understood. To gain insight into these mechanisms, we conducted a study comparing left atrial (LA) electroanatomic maps obtained during sinus rhythm between patients with paroxysmal AF (PAF) and patients with persistent AF (PerAF). Methods: The study included 23 men with PAF (age, 56.3±12.1 years) and 13 men with PerAF (age, 54.3±13.4 years). LA voltage mapping was performed during sinus rhythm. The clinical and electroanatomic characteristics of the two groups were evaluated and analyzed statistically. Results: The bipolar voltages at the LA septum, roof, and posterior wall, right superior pulmonary vein (PV) and its antrum, right superior PV carina, and right inferior PV antrum were significantly lower in patients with PerAF than in those with PAF. The bipolar voltages in other parts of the LA did not differ statistically between the two groups. Conclusion: PAF and PerAF seem to be characterized by differences in the regional voltage in the LA and PVs. The LA structural remodeling of PerAF may initiate from the right PVs and their antra and LA septum, roof, and posterior wall.

Keywords