Different patterns of atrial remodeling after catheter ablation of chronic atrial fibrillation

Li Wei Lo, Hsuan Ming Tsao, Yenn Jiang Lin, Shih Lin Chang, Yu Feng Hu, Wen Chin Tsai, Ta Chun Tuan, Kazuyoshi Suenari, Shih Yu Huang, Nguyen Huu Tung, Satoshi Higa, Ching Tai Tai, Kwo Chang Ueng, Cheng Hung Li, Tze Fan Chao, Tsu Juey Wu, Shih Ann Chen*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

23 Scopus citations


Atrial Substrate Remodeling After Chronic AF Ablation. Background: Multiple remodeling patterns have been observed after catheter ablation of atrial fibrillation (AF). Objective: We aimed to clarify the electrical/structural properties associated with recurrences after ablation of chronic AF. Methods: After a stepwise ablation procedure in 120 consecutive patients with persistent/long-lasting persistent AF, 36 had a recurrence of AF (Group 1/Group 2: recurrence with paroxysmal/persistent AF, n = 16/20). Results: During the first procedure, the left atrial (LA) bipolar voltage did not differ between the 2 groups, and the LA volume was smaller in Group 1 than in Group 2 and it was the only factor predicting the recurrent types (P = 0.009, OR = 1.04). In the second procedure, the bipolar voltage of the global left atrium increased (1.33 ± 0.11 mV vs 1.76 ± 0.16 mV, P = 0.001) in Group 1 and decreased (1.31 ± 0.14 mV vs 0.90 ± 0.12 mV, P = 0.01) in Group 2, when compared with that of the first procedure. The LA low-voltage area (<0.5 mV) decreased in Group 1, and increased in Group 2. The LA volume (90 ± 8 cm 3 vs 72 ± 8 cm 3, P = 0.002) decreased in the second procedure in Group 1. It remained the same in Group 2. The right atrial substrates did not change between the procedures. After a follow-up of 27 ± 3 months, all patients in Group 1 and 14 patients in Group 2 remained in sinus rhythm (P = 0.02). Conclusion: A better outcome with reverse electrical and structural remodeling occurred after the ablation of chronic AF when the recurrence was paroxysmal AF. Progressive electrical remodeling without any structural remodeling developed in those with a recurrence involving persistent AF.

Original languageEnglish
Pages (from-to)385-393
Number of pages9
JournalJournal of cardiovascular electrophysiology
Issue number4
StatePublished - Apr 2011


  • atrial fibrillation
  • catheter ablation
  • computed tomography
  • mapping
  • remodeling


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