Serum sST2 Correlates with Left Atrial Low-Voltage Areas and Is Associated With Procedure Outcome in Patients Undergoing Atrial Fibrillation Radiofrequency Ablation

Abstract

Objective: The present study was aimed to determine whether serum sST2，could be used as a marker of left atrial low voltage areas (LVAs) and it could be predicted the recurrence of AF in patients undergoing radiofrequency catheter ablation. Methods:84 cases (average age 64.24 ± 10.17, including 54 paroxysmal AF and 30 persistent AF ) undergoing radiofrequency ablation were finally included in the study. Electroanatomical voltage mapping was employed to determine the extent of left atrial low-voltage. LVAs were defined as bipolar electrogram amplitudes ≤0.5 mV during sinus rhythm. The general clinical data and hematological indexes of all patients were collected before ablation. All patients were followed up at 3, 6 and 12 months after RF procedure. Results: The primary outcome was sST2 could be used as a marker for the left atrial low voltage area (OR = 1.054, P < 0.05), and the serum level of sST2 had predictive value for the recurrence of AF after RFA (HR 1.014, 95% CI 0.986-1.035, P = 0.035). It was showed that there was 95% AF-free survival after ablation in the lower levels of serum sST2 whereas there was only 59.6% AF-free survival in the higher levels of serum sST2 according to the subgroup analysis. (Log Rank test, P=0.027). The secondary outcome was that serum sST2 combined with left atrium ateroposterior diameter (LAD) can further improve the prediction ability. Conclusions:sST2 may be a new biomarker in the assessment of atrial fibrosis and is associated with the recurrence of atrial fibrillation after radiofreqency ablatation.

Left Atrial Low Voltage Areas Predicts Recurrence of Atrial Fibrillation after Catheter Ablation: A Meta-Analysis

“…The basic information of the study is shown in Table 1 (Ref. [11,[18][19][20][21][22][23][24][25][26][27][28]) and the characteristics of each study are shown in Table 2 (Ref. [11,[18][19][20][21][22][23][24][25][26][27][28]).…”

“…6). Circular mapping catheter (Lasso) Yagishita/2017 [24] AF, LA voltage >0.5 mV 0.5-1.5 mV SR RF ablation (PV) Circular mapping catheter (Lasso) Tian/2014 [25] drug-refractory PAF <0.5 mV SR RF ablation (PV, tricuspid valvular isthmus) 10 pole mapping catheter (Lasso) Yan/2014 [26] drug-refractory AF 0.05-0.5 mV SR RF ablation (PV, the roof of the left atrium, mitral annulus) 10 pole mapping catheter (Lasso) Jia/2022 [27] AF <0. 5 mV SR or AF RF ablation (PV, the roof of the left atrium, coronary sinus) 20 pole mapping catheter (Pentaray) Chang/2007 [28] symptomatic drug-refractory AF Subgroup analysis according to atrial fibrillation type: atrial fibrillation type enrolled differed in the studies, 5 studies only included paroxysmal atrial fibrillation patients, 1 study only included non-paroxysmal atrial fibrillation patients, 6 studies included paroxysmal and non-paroxysmal atrial fibrillation patients.…”