ArticleJournal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing2020
Left atrial wall thickness is associated with the low-voltage area in patients with paroxysmal atrial fibrillation.
Article in Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Fibrosis-Guided Ablation in Patients With Atrial Fibrillation: A Meta-Analysis of Randomized Controlled Trials.Journal of cardiovascular electrophysiology · 2025Pooled it
- Mapping the Progression of Atrial Fibrillation Substrate: Insights from Left Atrial Wall Thickness and High-Density Voltage Mapping.Journal of clinical medicine · 2026Article
- Revisiting low-voltage interpretation: Chamber-specific relationships between myocardial wall thickness and omnipolar voltage.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2026Article
- Three-Dimensional Left Atrial Geometry in Atrial Fibrillation: Imaging Biomarkers, Substrate Phenotyping, and Ablation Outcome Prediction.Diagnostics (Basel, Switzerland) · 2026Review
- Segmental analysis of left atrial substrate severity predictors in patients undergoing persistent atrial fibrillation ablation.Frontiers in cardiovascular medicine · 2026Article
- Atrial fibrillation nomenclature, definitions, and mechanisms: Position paper from the international Working Group of the Signal Summit.Heart rhythm · 2025Review
- Quantification of atrial cardiomyopathy disease severity by electroanatomic voltage mapping and cardiac magnetic resonance imaging.Journal of cardiovascular electrophysiology · 2025Article
- Early Detection of Atrial Fibrillation in Chronic Obstructive Pulmonary Disease Patients.Medicina (Kaunas, Lithuania) · 2024Review
- Risk factors for new-onset atrial fibrillation during critical illness: A Delphi study.Journal of the Intensive Care Society · 2022Article
- The hunt for extra-pulmonary vein targets in persistent atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2022Article
- It Is Necessary to Re-understand the Low-Voltage Area in Atrial Fibrillation Patients.Frontiers in cardiovascular medicine · 2022Review
- New Discovery of Left Atrial Macroreentry Tachycardia: Originating from the Spontaneous Scarring of Left Atrial Anterior Wall.Journal of interventional cardiology · 2021Article
- Prediction of Atrial Fibrillation Using Machine Learning: A Review.Frontiers in physiology · 2021Review
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo identify a potential morphological marker of remodeling and electrophysiological dysfunction, we investigated if low wall thickness is associated with low-voltage areas (LVAs) in the left atrium.
methodsWall thickness was measured by computed tomography and LVA (% area with bipolar voltage < 0.5 mV) by voltage mapping in 43 paroxysmal AF patients. The left atrium was divided into five segments: septal wall, anterior wall, roof wall, posterior wall, and bottom wall in regional analysis.
resultsLeft atrial wall thickness and LVA were 3.2 ± 0.6 mm and 14% ± 9%, respectively. Multivariate analysis identified left atrial wall thickness and volume as independent determinants of left atrial LVA (thickness, standardized β - 0.374, 95%CI - 23.289 to - 4.534, P = 0.005; volume, standardized β 0.452, 95%CI 0.049-0.214, P = 0.002). In regional analysis, significant LVA (> 10% of segment surface area) was observed in 123 of 215 segments (57%). Segments in the low tertile of wall thickness (< 1.76 mm) had larger LVAs compared with segments in middle (1.76-2.14 mm) and high tertiles (≥ 2.14 mm) (low tertile, 20.3% ± 14.9%; middle tertile, 12.6% ± 11.2%; high tertile, 12.5% ± 12.1%; low vs. middle tertile, P = 0.001; low vs. high tertile, P = 0.001). Area under the receiver operating curve of wall thickness was 0.706 for prediction of significant LVA. A thickness cut-off of 1.90 mm yielded 62% sensitivity, 73% specificity, 75% positive predictive value, and 59% negative predictive value for significant LVA.
conclusionA thin left atrial wall is an independent predictor of LVA in patients with paroxysmal AF.
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