ArticlePloS one2018
Left atrial voltage, circulating biomarkers of fibrosis, and atrial fibrillation ablation. A prospective cohort study.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
26 citing papers in PubMed, 3 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- The prognostic value of left atrial low-voltage areas in atrial fibrillation recurrence after pulmonary vein isolation: a systematic review and meta-analysis.BMC cardiovascular disorders · 2026Pooled it
- Galectin-3 and risk of atrial fibrillation: A systematic review and meta-analysis.Journal of clinical laboratory analysis · 2020Pooled it
- Circulating Galectin-3 and Atrial Fibrillation Recurrence after Catheter Ablation: A Meta-Analysis.Cardiovascular therapeutics · 2019Pooled it
- Fibrosis-4 Index as a Marker of Systemic Fibrotic Burden and Its Association with Left Atrial Thrombus in Nonvalvular Paroxysmal Atrial Fibrillation.Journal of clinical medicine · 2026Article
- Atrial fibrillation substrate mapping with emphasis on voltage-based guidance.World journal of cardiology · 2025Review
- Circulating collagen type I fragments as specific biomarkers of cardiovascular outcome risk: Where are the opportunities?Matrix biology : journal of the International Society for Matrix Biology · 2025Review
- Correlation and Influencing Factor Analysis Between Gal-3 and Recurrent Patients With Nonvalvular Atrial Fibrillation After Radiofrequency Ablation.Cardiovascular therapeutics · 2025Article
- Factors predicting the recurrence of atrial fibrillation after catheter ablation: A review.Heliyon · 2024Review
- Role of Soluble ST2 Biomarker in Predicting Recurrence of Atrial Fibrillation after Electrical Cardioversion or Pulmonary Vein Isolation.International journal of molecular sciences · 2023Observational
- Evaluation of atrial fibrosis in atrial fibrillation patients with three different methods.Turkish journal of medical sciences · 2022Article
- Serum Lipopolysaccharide Is Associated with the Recurrence of Atrial Fibrillation after Radiofrequency Ablation by Increasing Systemic Inflammation and Atrial Fibrosis.Oxidative medicine and cellular longevity · 2022Article
- Left Atrial Cardiomyopathy - A Challenging Diagnosis.Frontiers in cardiovascular medicine · 2022Review
- Circulating Galectin-3 and Aldosterone for Predicting Atrial Fibrillation Recurrence after Radiofrequency Catheter Ablation.Cardiovascular therapeutics · 2022Article
- Atrial Fibrosis, Ischaemic Stroke and Atrial Fibrillation.Arrhythmia & electrophysiology review · 2021Review
- The Role of Galectin-3 and ST2 in Cardiology: A Short Review.Biomolecules · 2021Review
- Article
- A Review of Biomarkers for Ischemic Stroke Evaluation in Patients With Non-valvular Atrial Fibrillation.Frontiers in cardiovascular medicine · 2021Review
- Low voltage areas, atrial natriuretic peptides and fibrosis: Challenges and controversies.Clinical cardiology · 2021Article
- Atrial Myopathy Underlying Atrial Fibrillation.Arrhythmia & electrophysiology review · 2020Review
- Are the atrial natriuretic peptides a missing link predicting low-voltage areas in atrial fibrillation? Introducing the novel biomarker-based atrial fibrillation substrate prediction (ANP) score.Clinical cardiology · 2020Article
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsTo test the ability of four circulating biomarkers of fibrosis, and of low left atrial voltage, to predict recurrence of atrial fibrillation after catheter ablation.
backgroundCirculating biomarkers potentially may be used to improve patient selection for atrial fibrillation ablation. Low voltage areas in the left atrium predict arrhythmia recurrence when mapped in sinus rhythm. This study tested type III procollagen N terminal peptide (PIIINP), galectin-3 (gal-3), fibroblast growth factor 23 (FGF-23), and type I collagen C terminal telopeptide (ICTP), and whether low voltage areas in the left atrium predicted atrial fibrillation recurrence, irrespective of the rhythm during mapping.
methods92 atrial fibrillation ablation patients were studied. Biomarker levels in peripheral and intra-cardiac blood were measured with enzyme-linked immunosorbent assay. Low voltage (<0.5mV) was expressed as a proportion of the mapped left atrial surface area. Follow-up was one year. The primary endpoint was recurrence of arrhythmia. The secondary endpoint was a composite of recurrence despite two procedures, or after one procedure if no second procedure was undertaken.
resultsThe biomarkers were not predictive of either endpoint. After multivariate Cox regression analysis, high proportion of low voltage area in the left atrium was found to predict the primary endpoint in sinus rhythm mapping (hazard ratio 4.323, 95% confidence interval 1.337-13.982, p = 0.014) and atrial fibrillation mapping (hazard ratio 5.195, 95% confidence interval 1.032-26.141, p = 0.046). This effect was also apparent for the secondary endpoint.
conclusionThe studied biomarkers do not predict arrhythmia recurrence after catheter ablation. Left atrial voltage is an independent predictor of recurrence, whether the left atrium is mapped in atrial fibrillation or sinus rhythm.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.