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- Title
Low-voltage areas detected by high-density electroanatomical mapping predict recurrence after ablation for paroxysmal atrial fibrillation.
- Authors
Vlachos, Konstantinos; Efremidis, Michael; Letsas, Konstantinos P.; Bazoukis, George; Martin, Ruairidh; Kalafateli, Maria; Lioni, Louiza; Georgopoulos, Stamatis; Saplaouras, Athanasios; Efremidis, Theodore; Liu, Tong; Valkanas, Kosmas; Karamichalakis, Nikolaos; Asvestas, Dimitrios; Sideris, Antonios
- Abstract
Introduction We aimed to evaluate the extent of atrial fibrosis in paroxysmal atrial fibrillation (AF) and the correlation with ablation outcomes after pulmonary vein antral isolation (PVΑI) using a mapping system with high-resolution and high-spatial sampling. Methods and results We prospectively enrolled 80 consecutive patients (45 males, median age 60.26 years) with symptomatic paroxysmal AF who were scheduled for PVAI. Prior to PVAI, high-density bipolar voltage mapping (median number of 2,485 points) was carried out during sinus rhythm in all patients. Criteria for an adequate left atrium (LA) shell were > 2,000 points. Each acquired point was classified according to the peak-to-peak bipolar voltage electrogram based on two criteria (criterion A: healthy > 0.8 mV, border zone: 0.4-0.8 mV and scarred: < 0.4 mV, criterion Β: healthy: > 0.5 mV, border zone: 0.25-0.5 mV and scarred: < 0.25 mV). The extent of low-voltage area < 0.4 mV significantly predicted atrial tachyarrhythmia recurrence after the blanking period (P = 0.002). In univariate analysis, the presence of LA voltage areas < 0.4 mV more than 10% of the total surface area was the only significant predictor of arrhythmia recurrence. The analysis based on window B cutoff values failed to demonstrate any predictors of arrhythmia recurrence. Conclusion These data demonstrate that the existence of LA voltage areas < 0.4 mV more than 10% of the total LA surface area predicts arrhythmia recurrence following PVAI for paroxysmal AF.
- Subjects
ATRIAL fibrillation; CATHETER ablation; HEART atrium; STATISTICS; TACHYCARDIA; LEFT heart atrium
- Publication
Journal of Cardiovascular Electrophysiology, 2017, Vol 28, Issue 12, p1393
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/jce.13321