Atrial Myopathy and Ablation Outcomes - Histological, Functional and Mapping Considerations-Atrial Myopathy and Ablation Outcomes - Histological, Functional and Mapping Considerations

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Video Summary

The session, chaired by Naza Makoum from the University of Washington, focused on various approaches to assessing atrial myopathy and its outcomes. The session featured a lineup of speakers, each presenting their research findings.<br /><br />Dr. Natasha Dekrut discussed voltage mapping and atrial myopathy, emphasizing the challenges of defining low-voltage areas. She highlighted the influence of unipolar and bipolar electrograms on voltage maps and noted the variability in results based on technical and anatomical factors. Dr. Dekrut emphasized the need for improved understanding of the relationship between low-voltage areas and atrial fibrillation perpetuation.<br /><br />Dr. Yamaguchi from Saga University shared insights from histological evaluations of atrial biopsy samples. He demonstrated how atrial structural remodeling with factors like intercellular space, fibrosis, and amyloid deposition affects voltage readings. His work revealed a higher prevalence of amyloid deposition in atrial samples than expected, correlating with poor cardiovascular outcomes.<br /><br />Dr. Ahmed Qassar discussed the relationship between epicardial adiposity and atrial remodeling. His research at the University of Washington highlighted how increased epicardial adipose tissue volume is linked to impaired atrial function, lower conduction velocity, and increased low-voltage zones, thereby facilitating atrial fibrillation.<br /><br />Finally, Dr. Masuda presented findings from the SUPPRESS-AF trial, examining the efficacy of adding low-voltage area ablation to pulmonary vein isolation in persistent AF patients. While the additional ablation showed numerical benefit, it was not statistically significant for reducing recurrent atrial tachycardia or atrial fibrillation.<br /><br />The session concluded with a discussion about the complexities and multiple factors affecting atrial voltage mapping and remodeling, highlighting the need for refinement in assessment techniques.

Keywords

atrial myopathy

voltage mapping

atrial fibrillation

low-voltage areas

atrial remodeling

epicardial adiposity

amyloid deposition

pulmonary vein isolation

SUPPRESS-AF trial

cardiovascular outcomes