Bi-atrial characterization of the electrical substrate in patients with atrial fibrillation.
Bi-atrial characterization
atrial fibrillation
atrial substrate
electrograms
slow conduction
Journal
Pacing and clinical electrophysiology : PACE
ISSN: 1540-8159
Titre abrégé: Pacing Clin Electrophysiol
Pays: United States
ID NLM: 7803944
Informations de publication
Date de publication:
06 2022
06 2022
Historique:
revised:
19
02
2022
received:
27
12
2021
accepted:
11
03
2022
pubmed:
12
4
2022
medline:
22
6
2022
entrez:
11
4
2022
Statut:
ppublish
Résumé
Little is known regarding the characterization of electrical substrate in both atria in patients with atrial fibrillation (AF). Eight consecutive patients undergoing AF ablation (five paroxysmal, three persistent) underwent electrical substrate characterization during sinus rhythm. Mapping of the left (LA) and right atrium (RA) was performed with the use of the HD Grid catheter (Abbott). Bipolar voltage maps were analyzed to search for low voltage areas (LVA), the following electrophysiological phenomena were assessed: (1) slow conduction corridors, and (2) lines of block. EGMs were characterized to search for fractionation. Electrical characteristics were compared between atria and between paroxysmal versus persistent AF patients. In the RA, LVAs were present in 60% of patients with paroxysmal AF and 100% of patients with persistent AF. In the LA, LVAs were present in 40% of patients with paroxysmal AF and 66% of patients with persistent AF. The areas of LVA in the RA and LA were 4.8±7.3 cm Bi-atrial involvement is present in patients with paroxysmal and persistent AF. This is expressed by low voltage areas and slow conduction corridors whose extension progresses as the arrhythmia becomes persistent. This electrophysiological substrate demonstrates the important interplay with the pulmonary vein triggers to constitute the substrate for persistent arrhythmia.
Sections du résumé
BACKGROUND
Little is known regarding the characterization of electrical substrate in both atria in patients with atrial fibrillation (AF).
METHODS
Eight consecutive patients undergoing AF ablation (five paroxysmal, three persistent) underwent electrical substrate characterization during sinus rhythm. Mapping of the left (LA) and right atrium (RA) was performed with the use of the HD Grid catheter (Abbott). Bipolar voltage maps were analyzed to search for low voltage areas (LVA), the following electrophysiological phenomena were assessed: (1) slow conduction corridors, and (2) lines of block. EGMs were characterized to search for fractionation. Electrical characteristics were compared between atria and between paroxysmal versus persistent AF patients.
RESULTS
In the RA, LVAs were present in 60% of patients with paroxysmal AF and 100% of patients with persistent AF. In the LA, LVAs were present in 40% of patients with paroxysmal AF and 66% of patients with persistent AF. The areas of LVA in the RA and LA were 4.8±7.3 cm
CONCLUSION
Bi-atrial involvement is present in patients with paroxysmal and persistent AF. This is expressed by low voltage areas and slow conduction corridors whose extension progresses as the arrhythmia becomes persistent. This electrophysiological substrate demonstrates the important interplay with the pulmonary vein triggers to constitute the substrate for persistent arrhythmia.
Identifiants
pubmed: 35403246
doi: 10.1111/pace.14490
pmc: PMC9322275
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
752-760Informations de copyright
© 2022 The Authors. Pacing and Clinical Electrophysiology published by Wiley Periodicals LLC.
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