The electroanatomical remodelling of the left atrium is related to CHADS 2/CHA 2DS 2VASc score and events of stroke in patients with atrial fibrillation

Jae Hyung Park, Boyoung Joung, Nak Hoon Son, Jaemin Shim, Moon Hyung Lee, Chun Hwang, Hui Nam Pak

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

Background Although atrial fibrillation (AF) increases the risk of stroke, its relationship with atrial remodelling has not yet been studied. We hypothesized that the degree of electroanatomical remodelling of the left atrium (LA) is related to CHADS2/CHA2DS2VASc score and events of stroke. Methods and results We compared CHADS2/CHA2DS2VASc score (0, 1, ≥2) or events of stroke with mean and regional LA volume [by three-dimensional (3D) computed tomography images] or LA endocardial voltage (by 3D-electroanatomical map) in 348 patients who underwent catheter ablation of AF (78.4 male, 55.4±11.0 years old, paroxysmal AF:persistent AF 215:133). We graded LA volume index as Grade 1 (<48.3 mL/m 2; n = 80), grade 2 (48.3-63.0 mL/m 2, n = 82), grade 3 (63.0-99.0 mL/m 2; n = 94), and grade 4 (≥99.0 mL/m 2; n [ 92). Results (i) The percentage volume of anterior portion of LA enlarged at the early stage of LA remodelling (Grade 1 vs. grade 2, P = 0.006) and the voltage of posterior venous LA was significantly reduced with the degree of LA remodelling (P = 0.001). (ii) Mean LA volume/body surface area (BSA), especially anterior portion of LA, was greater in patients with high CHADS2/CHA2DS2VASc score (P = 0.002). Mean LA voltage was significantly lower in patients with high CHA2DS2VASc score than low score (P = 0.007). (iii) In patients who experience stroke (n = 22), LA volume/BSA, especially anterior LA, was greater (P = 0.012), and LA endocardial voltage was lower (P = 0.039) than those without stroke. Conclusion Electroanatomical remodelling of LA, estimated by LA volume and endocardial voltage, has significant relationship with the risk scores or events of stroke in patients with non-valvular AF.

Original languageEnglish
Pages (from-to)1541-1549
Number of pages9
JournalEuropace
Volume13
Issue number11
DOIs
Publication statusPublished - 2011 Nov 1
Externally publishedYes

Fingerprint

Heart Atria
Atrial Fibrillation
Stroke
Atrial Remodeling
Body Surface Area
Catheter Ablation

Keywords

  • Atrial fibrillation
  • CHADS score
  • Left atrium
  • Stroke
  • Voltage

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

The electroanatomical remodelling of the left atrium is related to CHADS 2/CHA 2DS 2VASc score and events of stroke in patients with atrial fibrillation. / Park, Jae Hyung; Joung, Boyoung; Son, Nak Hoon; Shim, Jaemin; Lee, Moon Hyung; Hwang, Chun; Pak, Hui Nam.

In: Europace, Vol. 13, No. 11, 01.11.2011, p. 1541-1549.

Research output: Contribution to journalArticle

Park, Jae Hyung ; Joung, Boyoung ; Son, Nak Hoon ; Shim, Jaemin ; Lee, Moon Hyung ; Hwang, Chun ; Pak, Hui Nam. / The electroanatomical remodelling of the left atrium is related to CHADS 2/CHA 2DS 2VASc score and events of stroke in patients with atrial fibrillation. In: Europace. 2011 ; Vol. 13, No. 11. pp. 1541-1549.
@article{b12c13934e284e32b9537fa78b89407f,
title = "The electroanatomical remodelling of the left atrium is related to CHADS 2/CHA 2DS 2VASc score and events of stroke in patients with atrial fibrillation",
abstract = "Background Although atrial fibrillation (AF) increases the risk of stroke, its relationship with atrial remodelling has not yet been studied. We hypothesized that the degree of electroanatomical remodelling of the left atrium (LA) is related to CHADS2/CHA2DS2VASc score and events of stroke. Methods and results We compared CHADS2/CHA2DS2VASc score (0, 1, ≥2) or events of stroke with mean and regional LA volume [by three-dimensional (3D) computed tomography images] or LA endocardial voltage (by 3D-electroanatomical map) in 348 patients who underwent catheter ablation of AF (78.4 male, 55.4±11.0 years old, paroxysmal AF:persistent AF 215:133). We graded LA volume index as Grade 1 (<48.3 mL/m 2; n = 80), grade 2 (48.3-63.0 mL/m 2, n = 82), grade 3 (63.0-99.0 mL/m 2; n = 94), and grade 4 (≥99.0 mL/m 2; n [ 92). Results (i) The percentage volume of anterior portion of LA enlarged at the early stage of LA remodelling (Grade 1 vs. grade 2, P = 0.006) and the voltage of posterior venous LA was significantly reduced with the degree of LA remodelling (P = 0.001). (ii) Mean LA volume/body surface area (BSA), especially anterior portion of LA, was greater in patients with high CHADS2/CHA2DS2VASc score (P = 0.002). Mean LA voltage was significantly lower in patients with high CHA2DS2VASc score than low score (P = 0.007). (iii) In patients who experience stroke (n = 22), LA volume/BSA, especially anterior LA, was greater (P = 0.012), and LA endocardial voltage was lower (P = 0.039) than those without stroke. Conclusion Electroanatomical remodelling of LA, estimated by LA volume and endocardial voltage, has significant relationship with the risk scores or events of stroke in patients with non-valvular AF.",
keywords = "Atrial fibrillation, CHADS score, Left atrium, Stroke, Voltage",
author = "Park, {Jae Hyung} and Boyoung Joung and Son, {Nak Hoon} and Jaemin Shim and Lee, {Moon Hyung} and Chun Hwang and Pak, {Hui Nam}",
year = "2011",
month = "11",
day = "1",
doi = "10.1093/europace/eur135",
language = "English",
volume = "13",
pages = "1541--1549",
journal = "Europace",
issn = "1099-5129",
publisher = "Oxford University Press",
number = "11",

}

TY - JOUR

T1 - The electroanatomical remodelling of the left atrium is related to CHADS 2/CHA 2DS 2VASc score and events of stroke in patients with atrial fibrillation

AU - Park, Jae Hyung

AU - Joung, Boyoung

AU - Son, Nak Hoon

AU - Shim, Jaemin

AU - Lee, Moon Hyung

AU - Hwang, Chun

AU - Pak, Hui Nam

PY - 2011/11/1

Y1 - 2011/11/1

N2 - Background Although atrial fibrillation (AF) increases the risk of stroke, its relationship with atrial remodelling has not yet been studied. We hypothesized that the degree of electroanatomical remodelling of the left atrium (LA) is related to CHADS2/CHA2DS2VASc score and events of stroke. Methods and results We compared CHADS2/CHA2DS2VASc score (0, 1, ≥2) or events of stroke with mean and regional LA volume [by three-dimensional (3D) computed tomography images] or LA endocardial voltage (by 3D-electroanatomical map) in 348 patients who underwent catheter ablation of AF (78.4 male, 55.4±11.0 years old, paroxysmal AF:persistent AF 215:133). We graded LA volume index as Grade 1 (<48.3 mL/m 2; n = 80), grade 2 (48.3-63.0 mL/m 2, n = 82), grade 3 (63.0-99.0 mL/m 2; n = 94), and grade 4 (≥99.0 mL/m 2; n [ 92). Results (i) The percentage volume of anterior portion of LA enlarged at the early stage of LA remodelling (Grade 1 vs. grade 2, P = 0.006) and the voltage of posterior venous LA was significantly reduced with the degree of LA remodelling (P = 0.001). (ii) Mean LA volume/body surface area (BSA), especially anterior portion of LA, was greater in patients with high CHADS2/CHA2DS2VASc score (P = 0.002). Mean LA voltage was significantly lower in patients with high CHA2DS2VASc score than low score (P = 0.007). (iii) In patients who experience stroke (n = 22), LA volume/BSA, especially anterior LA, was greater (P = 0.012), and LA endocardial voltage was lower (P = 0.039) than those without stroke. Conclusion Electroanatomical remodelling of LA, estimated by LA volume and endocardial voltage, has significant relationship with the risk scores or events of stroke in patients with non-valvular AF.

AB - Background Although atrial fibrillation (AF) increases the risk of stroke, its relationship with atrial remodelling has not yet been studied. We hypothesized that the degree of electroanatomical remodelling of the left atrium (LA) is related to CHADS2/CHA2DS2VASc score and events of stroke. Methods and results We compared CHADS2/CHA2DS2VASc score (0, 1, ≥2) or events of stroke with mean and regional LA volume [by three-dimensional (3D) computed tomography images] or LA endocardial voltage (by 3D-electroanatomical map) in 348 patients who underwent catheter ablation of AF (78.4 male, 55.4±11.0 years old, paroxysmal AF:persistent AF 215:133). We graded LA volume index as Grade 1 (<48.3 mL/m 2; n = 80), grade 2 (48.3-63.0 mL/m 2, n = 82), grade 3 (63.0-99.0 mL/m 2; n = 94), and grade 4 (≥99.0 mL/m 2; n [ 92). Results (i) The percentage volume of anterior portion of LA enlarged at the early stage of LA remodelling (Grade 1 vs. grade 2, P = 0.006) and the voltage of posterior venous LA was significantly reduced with the degree of LA remodelling (P = 0.001). (ii) Mean LA volume/body surface area (BSA), especially anterior portion of LA, was greater in patients with high CHADS2/CHA2DS2VASc score (P = 0.002). Mean LA voltage was significantly lower in patients with high CHA2DS2VASc score than low score (P = 0.007). (iii) In patients who experience stroke (n = 22), LA volume/BSA, especially anterior LA, was greater (P = 0.012), and LA endocardial voltage was lower (P = 0.039) than those without stroke. Conclusion Electroanatomical remodelling of LA, estimated by LA volume and endocardial voltage, has significant relationship with the risk scores or events of stroke in patients with non-valvular AF.

KW - Atrial fibrillation

KW - CHADS score

KW - Left atrium

KW - Stroke

KW - Voltage

UR - http://www.scopus.com/inward/record.url?scp=80054948846&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80054948846&partnerID=8YFLogxK

U2 - 10.1093/europace/eur135

DO - 10.1093/europace/eur135

M3 - Article

VL - 13

SP - 1541

EP - 1549

JO - Europace

JF - Europace

SN - 1099-5129

IS - 11

ER -