Key result
Abnormal atrial potentials during sinus rhythm overlap with ~93% of slow conduction areas during AT.
Why the study?
Abnormal atrial potentials during sinus rhythm or pacing may indicate slow conduction supporting reentrant AT, motivating an investigation into their relationship with AT circuits.
Do abnormal atrial potentials recorded during sinus rhythm or pacing correlate with areas of slow conduction in reentrant atrial tachycardia circuits?
Observational (n=104)
Do abnormal atrial potentials recorded during sinus rhythm or pacing correlate with areas of slow conduction in reentrant atrial tachycardia circuits?
Abnormal atrial potentials recorded during sinus rhythm or pacing strongly correlate with areas of slow conduction in reentrant atrial tachycardia, providing a potential substrate mapping target.
AAPs during sinus rhythm may mark slow conduction zones in reentrant AT; hypothesis-generating for substrate mapping and requires prospective validation.
BACKGROUND: Abnormal atrial potentials (AAPs) recorded during sinus rhythm/atrial pacing may indicate areas of slow conduction capable of supporting reentrant atrial tachycardia (AT). Therefore, we sought to examine the relationship between AAPs and AT circuits. METHODS: One hundred twenty-three reentrant ATs in 104 patients were analyzed. AAPs, consisting of fragmented potentials and split potentials, were assessed using the Rhythmia LUMIPOINT algorithm. RESULTS: There was 93±13% overlap between areas with AAPs during sinus rhythm/atrial pacing and areas of slow conduction along the reentry circuit during AT. The cumulative area of AAPs was smaller in patients with localized-reentrant ATs compared with anatomic macro-reentrant ATs (20.0 [14.6–30.5] versus 28.9 [21.8–35.6] cm 2 ; P =0.021). Patients with perimitral ATs had larger areas of AAPs on the lateral wall whereas patients with roof-dependent ATs had larger areas of AAPs on the roof and posterior wall ( P ≤0.018 for all comparisons). The patchy scar that was associated with localized-reentrant AT exhibited a larger area of AAPs at its periphery than the scar that did not participate in localized-reentrant AT (3.1 [2.4–4.5] versus 1.0 [0.7–1.6] cm 2 ; P <0.001). CONCLUSIONS: AAPs recorded during sinus rhythm/atrial pacing are associated with areas of slow conduction during reentrant AT. The burden and distribution of AAPs may provide actionable insights into AT circuit features, including in cases in which ATs are difficult to map.
No takes yet. Share an insight, caveat, or question.
Nakatani et al. (2023) conducted an observational in Reentrant atrial tachycardia (n=104). Abnormal atrial potentials (AAPs) was evaluated on Overlap between areas with AAPs during sinus rhythm/atrial pacing and areas of slow conduction along the reentry circuit during AT. Abnormal atrial potentials recorded during sinus rhythm or atrial pacing had a 93±13% overlap with areas of slow conduction during reentrant atrial tachycardia.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: