ArticleHeart rhythm2019
Structural remodeling and conduction velocity dynamics in the human left atrium: Relationship with reentrant mechanisms sustaining atrial fibrillation.
Article in Heart rhythm, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 43 papers, 1 of them a synthesis that pooled it.
What it found
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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
43 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review and meta-analysis of the safety and efficacy of left atrial substrate modification in atrial fibrillation patients with low voltage areas.Frontiers in cardiovascular medicine · 2022Pooled it
- Utility of slow conduction velocity area guided ablation in patients with persistent atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Artificial Intelligence for Precision Antiarrhythmic Drug Therapy in Atrial Fibrillation: From Recurrence Prediction to Comparative Treatment Selection.Medicina (Kaunas, Lithuania) · 2026Review
- Acute Termination of Atrial Fibrillation During Ablation of a Left Atrial Slow-Conduction Channel.Journal of cardiovascular electrophysiology · 2026Article
- Divergent mitochondrial and fibrotic signatures in atrial fibrillation: insights from organoids and GEO data.Cardiovascular diabetology · 2026Article
- Atrial fibrosis in atrial fibrillation: Mechanisms, mapping techniques and clinical applications.The Journal of physiology · 2026Review
- Influence of Anatomical Definition and Substrate Condition on Simulations of Atrial Arrhythmias.Annals of biomedical engineering · 2026Article
- Neural Regulation of Cardiac Arrhythmias: From the Brain-Heart Axis to Emerging Precision Therapies.Research (Washington, D.C.) · 2026Review
- Atrial FDG avidity is associated with reduced atrial strain and contractility independent of atrial fibrillation and cardiac sarcoidosis.European heart journal. Imaging methods and practice · 2026Article
- Targeting the Ubiquitin-Proteasome System in Atrial Fibrillation: Mechanistic Insights and Translational Perspectives.Current issues in molecular biology · 2025Review
- Regional heterogeneity in left atrial stiffness impacts passive deformation in a cohort of patient-specific models.PLoS computational biology · 2025Article
- High-density evaluation of the arrhythmogenic substrate in persistent atrial fibrillation.Heart rhythm O2 · 2025Article
- Left atrial deceleration outperforms regional conduction velocity in predicting arrhythmia recurrence following atrial fibrillation ablation.Heart rhythm O2 · 2025Article
- Mechanistic Pathways Underlying Genetic Predisposition to Atrial Fibrillation Are Associated With Different Cardiac Phenotypes and Cardioembolic Stroke Risk.Circulation. Genomic and precision medicine · 2025Article
- Functional and Structural Remodeling as Atrial Fibrillation Progresses in a Persistent Atrial Fibrillation Canine Model.JACC. Clinical electrophysiology · 2025Article
- Identifying extra pulmonary vein targets for persistent atrial fibrillation ablation: bridging advanced and conventional mapping techniques.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2025Article
- Investigating the mechanisms of small extracellular vesicles in cardiovascular disease using the living myocardial slice platform.Frontiers in cardiovascular medicine · 2025Review
- Multi-modal integration of MRI and global chamber charge density mapping for the evaluation of atrial fibrillation.Royal Society open science · 2025Article
- The effect of fixed and functional remodelling on conduction velocity, wavefront propagation, and rotational activity formation in atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Atrial Fibrillation and Underlying Structural and Electrophysiological Heterogeneity.International journal of molecular sciences · 2024Review
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundRate-dependent conduction velocity (CV) slowing is associated with atrial fibrillation (AF) initiation and reentrant mechanisms.
objectiveThe purpose of this study was to assess the relationship between bipolar voltage, CV dynamics, and AF drivers.
methodsPatients undergoing catheter ablation for persistent AF (<24 months) were enrolled. Unipolar electrograms were recorded with a 64-pole basket catheter during atrial pacing at 4 pacing intervals (PIs) during sinus rhythm. CVs were measured between pole pairs along the wavefront path and correlated with underlying bipolar voltage. CV dynamics within low-voltage zones (LVZs <0.5 mV) were compared to those of non-LVZs (≥0.5 mV) and were correlated to driver sites mapped using CARTOFINDER (Biosense Webster).
resultsEighteen patients were included (age 62 ± 10 years). Mean CV at 600 ms was 1.59 ± 0.13 m/s in non-LVZs vs 0.98 ± 0.23 m/s in LVZs (P <.001). CV decreased incrementally over all 4 PIs in LVZs, whereas in non-LVZs a substantial decrease in CV was only seen between PIs 300-250 ms (0.59 ± 0.09 m/s; P <.001). Rate-dependent CV slowing sites measurements, defined as exhibiting CV reduction ≥20% more than the mean CV reduction seen between PIs 600-250 ms for that voltage zone, were predominantly in LVZs (0.2-0.5 mV; 75.6% ± 15.5%; P <.001). Confirmed rotational drivers were mapped to these sites in 94.1% of cases (sensitivity 94.1%, 95% CI 71.3%-99.9%; specificity 77.9%, 95% CI 74.9%-80.7%).
conclusionCV dynamics are determined largely by the extent of remodeling. Rate-dependent CV slowing sites are predominantly confined to LVZs (0.2-0.5 mV), and the resultant CV heterogeneity may promote driver formation in AF.
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