Higher Degree of Left Atrial Structural Remodeling in Patients with Atrial Fibrillation and Left Ventricular Systolic Dysfunction

Abstract

Patients with LV systolic dysfunction displayed a comparatively greater LA-SRM than patients with normal LVEF. Patients with lesser LA-SRM experienced a greater improvement in LVEF after catheter ablation for AF.

Importance of non–pulmonary vein triggers ablation to achieve long-term freedom from paroxysmal atrial fibrillation in patients with low ejection fraction

“…28 Fibrosis and ischemia can promote AF facilitating non-PV triggers by means of abnormal automaticity, triggered activity or re-entry. [27][28][29][30] Non-PV triggers by themselves are known strong predictors of ATa recurrences: many studies have shown that their presence in the index procedure is associated with long-term AF recurrence, even in patients with PAF. [31][32][33] 15…”

“…20,27 LVSD is associated with elevation of LV filling pressures, with consequent increase of atrial wall tension leading to LA stretch and chronic dilatation. This is a known trigger of atrial fibrosis in HF patients, along with angiotensin II, aldosterone, oxidative stress, and inflammation.…”

Effects of Persistent Atrial Fibrillation on Serum Galectin-3 Levels

“…Although the association between atrial fibrillation (AF) and atrial fibrosis has been highlighted in several studies [8][9][10][11] , the role of galectin-3 in the pathogenesis of these two conditions has not been evaluated thoroughly yet. In a recent study, higher circulating galectin-3 concentrations were found to be associated with increased risk of AF development over the subsequent 10 years in age-and sex-adjusted analyses 12 .…”

Relation between left atrial wall composition by late gadolinium enhancement and complex fractionated atrial electrograms in patients with persistent atrial fibrillation: influence of non-fibrotic substrate in the left atrium

“…Generally, patients with more remodeled LA wall have more extensive LA fibrosis than those with less remodeled LA wall [20,21]. An appreciable correlation between LA fibrosis and low voltage (\0.5 mV) has been demonstrated [21,22].…”

“…LGE-CMR has been emerging as a powerful technique for identifying the hyperenhancement of fibrosis even in the thin LA wall [18][19][20]. Generally, patients with more remodeled LA wall have more extensive LA fibrosis than those with less remodeled LA wall [20,21].…”