The relationship between left atrial low-voltage areas and silent cerebral infarction after radiofrequency catheter ablation in patients with atrial fibrillation
LIU Chen
CHEN Lei
DU Xin-jia
Eric Nzayisensa
LI Cheng-zong
CHEN Wen-su
ZHANG Zhuo-qi
Abstract：Objective This study aims to investigate the relationship between left atrial low-voltage areas(LA-LVAs)and silent cerebral infarction(SCI)following radiofrequency catheter ablation(RFCA)in patients with atrial fibrillation(AF).Methods This is a single-center,prospective observational study that included 347 AF patients who underwent their first RFCA at the Affiliated Hospital of Xuzhou Medical University between October 2019 and May 2024.All patients underwent brain diffusion-weighted magnetic resonance imaging(DWMRI)within 48 hours post-procedure to confirm SCI presence or absence.Relevant clinical data were recorded,and intraoperative LA-LVAs％was measured.Logistic regression analysis was conducted to identify potential risk factors associated with the occurrence of SCI.Receiver operating characteristic(ROC)curves were constructed to evaluate the diagnostic effectiveness of the parameters for SCI.Results Of the 347 AF patients,57(16.42％)developed SCI following RFCA.After adjusting for confounding factors,multivariate regression analysis revealed that LA-LVAs％(OR=1.06,95％CI 1.03-1.10,P＜0.001),average ACT(OR=0.98,95％CI 0.96-0.99,P=0.001,and intraoperative electrical cardioversion(OR=2.39,95％CI 1.06-5.37,P=0.035)were independent risk factors for SCI occurrence.ROC curve analysis showed that incorporating LA-LVAs％significantly enhanced the clinical model's predictive accuracy for SCI occurrence following RFCA in AF patients(Net Reclassification Index(NRI)=0.467,(95％CI 0.2054-0.7304,P＜0.001),Integrated Discrimination Improvement(IDI)=0.076,(95％CI 0.027-0.1302,P=0.001).Conclusion LA-LVASs are an independent risk factor for SCI following RFCA in AF patients.Integrating LA-LVAs％significantly improves the SCI risk model following RFCA in AF patients.
Keywords：Silent cerebral infarctionLeft atrial low-voltage areasAtrial fibrillationRadiofrequency catheter ablation
Publication Date：2025-05-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 447-452 )