AUTHORS
Radoslaw Marek Kiedrowicz MD, PhD. Pomeranian Medical
University, Cardiology Department, Powstancow Wlkp. 72, 70-111 Szczecin,
Poland ; email: radkied@wp.pl ;
phone: +48509395560; fax: +48914661379 (Corresponding Author)
Maciej Wielusinski MD. Pomeranian Medical University,
Cardiology Department, Szczecin, Poland
Andrzej Wojtarowicz MD, PhD. Pomeranian Medical University,
Cardiology Department, Szczecin, Poland
Jaroslaw Kazmierczak MD, PhD, Professor of Cardiology.
Pomeranian Medical University, Cardiology Department, Szczecin, Poland
FUNDING
This work was supported by the Minister of Science and Higher Education
[Regional Initiative of Excellence 002/RID/2018/19]
ABSTRACT
Background: Right atrial (RA) size and function are not well
described in long-standing persistent AF (LSPAF) patients, nor their
value as a predictor for the left atrial (LA) voltage-defined fibrosis.
Methods: An evaluation was made as to whether echocardiography
determined RA length, planimetered area, volume, emptying fraction,
stroke volume, expansion index and calculated derivates among the LSPSAF
population predict LA low voltage areas (LVA) acquired with high-density
and high-resolution bipolar voltage mapping using the CARTO®3 system.
Results: 142 patients aged 63 (58-67) years old, 117 males,
were enrolled in our study. LVA were detected in 54% of the patients.
Severe global LVA burden was present in 15% of the patients, whereas
30% of the patients presented a disseminated pattern of remodelling. We
have shown that (1) the majority of the study population (76%)
presented enlarged RA, however RA volumes were larger than LA volumes in
the minority of cases (2) RA enlargement had a positive correlation with
the presence of mild-to-moderate tricuspid regurgitation, left
ventricular hypertrophy, LA enlargement, LA area and volume (3), none of
the RA indices were associated with the prediction of absolute LVA or
advanced LA fibrotic remodelling, although patients with severe LVA
burden presented longer RA length and a larger area than comparing to
patients with less advanced remodelling pattern.
Conclusions: It was found that RA enlargement and decreased RA
function, common in LSPSAF patients, do not translate to the presence of
voltage-derived LA fibrotic remodelling