Key result
Electroanatomic voltage mapping during atrial fibrillation rhythm was feasible, with an optimal cutoff value of 0.2 mV for detecting low-voltage areas ≤0.5 mV during sinus rhythm (R=0.88, P<0.001).
Why the study?
Electroanatomic voltage mapping of the left atrium is usually acquired during sinus rhythm, and the feasibility of mapping during atrial fibrillation rhythm is unclear.
What is the optimal cutoff value for low-voltage area in electroanatomic voltage mapping during atrial fibrillation compared to sinus rhythm in patients undergoing AF ablation?
Observational (n=44)
What is the optimal cutoff value for low-voltage area in electroanatomic voltage mapping during atrial fibrillation compared to sinus rhythm in patients undergoing AF ablation?
Electroanatomic voltage mapping during atrial fibrillation is feasible, with an optimal bipolar low-voltage cutoff of 0.2 mV corresponding to the standard 0.5 mV cutoff during sinus rhythm.
Answers are grounded in this paper and cite their sources.
0.2 mV AF cutoff approximates SR 0.5 mV LVA proportions; leaves open prospective validation for ablation guidance.
BACKGROUND: Electroanatomic voltage mapping (EAVM) of the left atrium (LA) with multielectrodes is usually acquired during sinus rhythm (SR), and the feasibility of EAVM during atrial fibrillation (AF) rhythm is unclear. METHODS: We performed EAVM of LA during both SR and AF rhythm in 44 patients undergoing catheter ablation for AF and validated the optimal cutoff value of low-voltage area (LVA) during AF rhythm for detecting LVA defined as bipolar voltages ≤0.5 mV during SR. Differences of LVA proportions between SR and AF rhythm were 5.8% (P < 0.001), 4.2% (P < 0.001), 2.7% (P < 0.001), 1.2% (P = 0.01), and -0.5% (P = 0.17) at the cutoff value of 0.4, 0.35, 0.3, 0.25, and 0.2 mV during AF rhythm, respectively. There was a good correlation between LVA proportions during SR and AF rhythm with cutoff value of 0.2 mV (R = 0.88, P < 0.001) and 37 patients (84.1%) had the discrepancy of LVA proportions within 3%. Furthermore, there was no significant difference between LVA proportions at each segment of LA. The discrepancy was relatively large in patients with large LA dimension and LVA during SR. CONCLUSION: EAVM during AF rhythm was feasible and the optimal cutoff value of LVA was 0.2 mV for detecting LVA ≤ 0.5 mV during SR. However, the evidence is restricted to patients with relatively small LVA.
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Kawaji et al. (2019) conducted an observational in Atrial fibrillation (n=44). Electroanatomic voltage mapping during AF rhythm vs. Electroanatomic voltage mapping during sinus rhythm was evaluated on Difference in low-voltage area (LVA) proportions between SR and AF rhythm (R = 0.88, p=<0.001). Electroanatomic voltage mapping during atrial fibrillation rhythm was feasible, with an optimal cutoff value of 0.2 mV for detecting low-voltage areas ≤0.5 mV during sinus rhythm (R=0.88, P<0.001).
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