Atrial low voltage areas: A comparison between atrial fibrillation and sinus rhythm
Background: Atrial fibrosis can promote atrial fibrillation (AF). Electroanatamic mapping (EAM) can provide information regarding local voltage abnormalities that may be used as a surrogate marker for fibrosis. Specific voltage cut-off values have been reproduced accurately to identify fibrosis in t...
| Autores: | , , , , , , , , |
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| Formato: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2022 |
| País: | España |
| Recursos: | Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
| Repositorio: | r-FISABIO. Repositorio Institucional de Producción Científica |
| OAI Identifier: | oai:fisabio.fundanetsuite.com:p16637 |
| Acesso em linha: | https://fisabio.portalinvestigacion.com/publicaciones/16637 |
| Access Level: | acceso abierto |
| Palavra-chave: | atrial fibrillation electroanatomic mapping low-voltage areas atrial fibrosis threshold pulmonary vein isolation |
| Resumo: | Background: Atrial fibrosis can promote atrial fibrillation (AF). Electroanatamic mapping (EAM) can provide information regarding local voltage abnormalities that may be used as a surrogate marker for fibrosis. Specific voltage cut-off values have been reproduced accurately to identify fibrosis in the ventricles, but these values are not well defined in atrial tissue. Methods: This study is a prospective single-center study. Patients with persistent AF referred for ablation were included. EAM was performed before ablation. We recorded bipolar signals, first in AF and later in sinus rhythm (SR). Two thresholds delimited low-voltage areas (LVA), 0.5 and 0.3 mV We compared LVA extension between maps in SR and AF in each patient. Results: A total of 23 patients were included in the study. The percentage of oints with voltage lower than 0.5 mV and 0.3 mV was significantly higher in maps in AF compared with maps in SR: 38.2% of oints < 0.5 mV in AF vs. 22.9% in SR (p < 0.001); 22.3% of points < 0.3 mV in AF vs. 14% in SR (p < 0.001). Areas with reduced voltage were significantly larger in maps in AF (0.5 mV threslwld, mean area in AF 41.3 +/- 42.5 cm(2) vs. 11.7 +/- 17.9 cm(2) in SR, p < 0.001; 0.3 mV threshold, mean area in AF 15.6 +/- 22.1 cm(2) vs. 6.2 +/- 11.5 cm(2) in SR p < 0.001). Conclusions: Using the same voltage thresholds, LVA extension in AF is greater than in SR in patients with persistent AR These findings provide arguments for defining a different atrial fibrosis threshold based on EAM rhythm. |
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