Prediction of low-voltage areas in the left atrium in patients with non-valvular atrial fibrillation by non-invasive markers

Aim. To develop a method for predicting the area of low-voltage (LVA) in left atrium (LA), associated with minimum and maximum expected effectiveness primary radiofrequency ablation (RFA) patients non-valvular atrial fibrillation (AF) using non-invasive predictors. Methods. A longitudinal single-center study included 150 symptomatic AF pts aged 20-72 years (median 59.0 [51.0; 64.0]), including 63 women (42%) hospitalized RFA; 119 (79.3%) had paroxysmal 31 (20.7%) - persistent AF. All initially underwent general clinical examination, transesophageal advanced transthoracic echocardiography, estimation NT-proBNP (pg/ml) growth differentiation factor 15 (GDF-15, pg/ml) blood. Electroanatomical mapping was performed sinus rhythm before RFA. The LVA (<0.5 mV) calculated as percentage total LA area. Left ventricular (LV) ejection fraction (LVEF) >50% all pts. Results. varied from 0 to 95.3%, median 13.7% [5.1; 30.9]. Depending on area, were divided into 3 groups: 36 (<5%) gr. 1; 74 (5-30%) 2; 40 (>30%) 3. Increase age, presence, severity congestive heart failure (CHF), AF, CHA 2 DS -VASc score ≥3 points, increase volume, LV hypertrophy GDF-15 levels. In univariate analysis, <5% level <125 pg/ml, absence obesity CHF, lower volume index (<28 ml/ m ). Independent predictors were: ≤28 . model good quality, C-statistics 0.775 (p<0.001). >30 % age >60 years, >125 >840 presence hypertrophy, LVEF ≤60%, ≥ 32 ml/m >30% ≥32 , ≤60%. 0.752 Conclusion. Evaluation noninvasive parameters, characteristics, echocardiographic blood levels GDF-15, allows prediction electroanatomical substrate referred