ArticleEuropean heart journal2023
Histological validation of atrial structural remodelling in patients with atrial fibrillation.
Article in European heart journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 77 papers, 3 of them syntheses that pooled it.
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Who cites it
77 citing papers in PubMed, 3 syntheses or guidelines pooled it, 112 citations in OpenAlex.
- Prevalence and multiple predictors of left atrial low voltage in paroxysmal and non-paroxysmal atrial fibrillation patients undergoing ablation: a systematic review and meta-analysis.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 · 2025Pooled it
- Beyond the beats: a systematic review of the underlying inflammatory pathways between atrial fibrillation and cognitive decline.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Pooled it
- Efficacy and safety of catheter ablation for atrial fibrillation in patients with heart failure with preserved ejection fraction: a systematic review and meta-analysis.Frontiers in cardiovascular medicine · 2024Pooled it
- Clinical Impact of Interlesion Distance on Acute Pulmonary Vein Isolation Success in Patients With Paroxysmal Atrial Fibrillation.Circulation reports · 2026Trial
- Impact of Diabetes on the Efficacy of Low-Voltage Area Ablation for Persistent Atrial Fibrillation: A Subanalysis of the SUPPRESS-AF Trial.Journal of the American Heart Association · 2026Trial
- Impact of renal function on the efficacy of low-voltage area ablation after pulmonary vein isolation: a sub-analysis of the SUPPRESS-AF trial.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 · 2025Trial
- Persistent atrial fibrillation with left atrial low-voltage area: who benefit from additional modification?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 · 2025Trial
- Low-voltage-area ablation for persistent atrial fibrillation: a randomized controlled trial.Nature medicine · 2025Trial
- Association Between Mean Left Atrial Voltage and Prior Ischemic Stroke in Atrial Fibrillation: A Single-Center Cross-Sectional Study.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
- Relationship between serum circulating Syndecan-1 levels and myocardial fibrosis and major adverse cardiovascular events in elderly patients with atrial fibrillation.Heart and vessels · 2026Article
- Three-Dimensional Left Atrial Geometry in Atrial Fibrillation: Imaging Biomarkers, Substrate Phenotyping, and Ablation Outcome Prediction.Diagnostics (Basel, Switzerland) · 2026Review
- Divergent mitochondrial and fibrotic signatures in atrial fibrillation: insights from organoids and GEO data.Cardiovascular diabetology · 2026Article
- Association of Myocardial Degeneration With Delayed Recovery of Left Ventricular Function in Atrial Fibrillation-Induced Cardiomyopathy.Circulation reports · 2026Article
- The clinical pathophysiology of atrial fibrillation: outstanding questions from bedside to bench and back.Physiological reviews · 2026Review
- Pacing-lead sheath method-directed right atrial septal endomyocardial biopsy in identifying arrhythmogenic right ventricular cardiomyopathy: A case report.HeartRhythm case reports · 2026Article
- Epigenetics in Atrial Fibrillation: Molecular Mechanisms and Therapeutic Avenues.Reviews in cardiovascular medicine · 2026Review
- Atrial fibrosis in atrial fibrillation: Mechanisms, mapping techniques and clinical applications.The Journal of physiology · 2026Review
- Computed Tomography-Derived Left Ventricular Extracellular Volume Predicts Reverse Remodeling After Catheter Ablation for Atrial Fibrillation.Journal of cardiovascular development and disease · 2026Article
- Mitochondrial dysfunction drives ZBP1-mediated PANoptosis to increase the susceptibility of heart failure with preserved ejection fraction-associated atrial fibrillation.Journal of advanced research · 2026Article
17 more citing papers are in PubMed but not listed here.
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Authors and funding
14 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsThis study aimed to histologically validate atrial structural remodelling associated with atrial fibrillation. METHODS AND
resultsPatients undergoing atrial fibrillation ablation and endomyocardial atrial biopsy were included (n = 230; 67 ± 12 years old; 69 women). Electroanatomic mapping was performed during right atrial pacing. Voltage at the biopsy site (Vbiopsy), global left atrial voltage (VGLA), and the proportion of points with fractionated electrograms defined as ≥5 deflections in each electrogram (%Fractionated EGM) were evaluated. SCZtotal was calculated as the total width of slow conduction zones, defined as regions with a conduction velocity of <30 cm/s. Histological factors potentially associated with electroanatomic characteristics were evaluated using multiple linear regression analyses. Ultrastructural features and immune cell infiltration were evaluated by electron microscopy and immunohistochemical staining in 33 and 60 patients, respectively. Fibrosis, intercellular space, myofibrillar loss, and myocardial nuclear density were significantly associated with Vbiopsy (P = .014, P < .001, P < .001, and P = .002, respectively) and VGLA (P = .010, P < .001, P = .001, and P < .001, respectively). The intercellular space was associated with the %Fractionated EGM (P = .001). Fibrosis, intercellular space, and myofibrillar loss were associated with SCZtotal (P = .028, P < .001, and P = .015, respectively). Electron microscopy confirmed plasma components and immature collagen fibrils in the increased intercellular space and myofilament lysis in cardiomyocytes, depending on myofibrillar loss. Among the histological factors, the severity of myofibrillar loss was associated with an increase in macrophage infiltration.
conclusionHistological correlates of atrial structural remodelling were fibrosis, increased intercellular space, myofibrillar loss, and decreased nuclear density. Each histological component was defined using electron microscopy and immunohistochemistry studies.
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