Key result
Left atrial AF voltages correlate with SR voltages, predicting low-voltage zones below 0.2 mV.
Why the study?
Can low-voltage zones identified during atrial fibrillation predict low-voltage zones during sinus rhythm?
Observational (n=8)
No
Can low-voltage zones identified during atrial fibrillation predict low-voltage zones during sinus rhythm?
Effect estimate: r = 0.74
p-value: p=<0.0001
Low-voltage zones during sinus rhythm can be accurately predicted by mapping during atrial fibrillation using a lower voltage threshold of 0.2 mV.
May support AF-only mapping to identify sinus rhythm low-voltage zones; leaves open prospective validation before clinical adoption.
Background: As we have found a significant correlation between left atrial (LA) voltage during sinus rhythm (SR) and that during atrial fibrillation (AF), we hypothesized that the existence of low-voltage zones (LVZs) during AF can be used to identify LVZs during SR. Therefore, we conducted a study to test this hypothesis. Methods: In 8 patients, high-density bipolar voltage mapping (> 300 points) of the left atrium was performed with a 20-pole circular catheter with 4-4-4-mm interelectrode spacing. The left atrium was divided into 7 segments, and the mean LA bipolar voltages recorded over 5 seconds during SR and AF were determined by measurement of the peak-to-peak amplitudes. Results: LVZs identified at each segment were compared between SR and AF. LA bipolar voltages obtained during SR and AF correlated positively (r = 0.74, p < 0.0001). With the low voltage during SR defined as < 0.5 mV, the low voltage of < 0.2 mV during AF approximately matched the low LVZs mapped during SR. Conclusions: These findings indicate that LVZs of < 0.5 mV during SR could be predicted from LVZs identified during AF by designating a threshold AF voltage of 0.2 mV.
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Takahashi et al. (2018) conducted an observational in Atrial fibrillation (n=8). Left atrial bipolar voltage mapping during atrial fibrillation vs. Left atrial bipolar voltage mapping during sinus rhythm was evaluated on Correlation of left atrial bipolar voltages between sinus rhythm and atrial fibrillation (r = 0.74, p=<0.0001). Left atrial voltages during atrial fibrillation correlated with those during sinus rhythm (r = 0.74, p < 0.0001), allowing prediction of sinus rhythm low-voltage zones using a <0.2 mV threshold.
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