In patients with persistent AF, electrogram amplitude was significantly lower during AF compared to sinus rhythm (0.96 ± 0.77 mV vs 1.77 ± 1.27 mV, P < 0.0001).
Observational (n=30)
Does left atrial voltage and electrogram fractionation differ between sinus rhythm and atrial fibrillation at identical locations in patients with persistent AF?
Significant differences in electrogram voltage and fractionation degree exist between sinus rhythm and atrial fibrillation at the same locations, which may impact low-voltage-guided ablation strategies.
Absolute Event Rate: 0.96% vs 1.77%
p-value: p=< 0.0001
BACKGROUND: The efficacy of low-voltage-guided ablation in addition to pulmonary vein (PV) isolation for atrial fibrillation (AF) has been reported with voltage mapping being performed during sinus rhythm (SR) or AF. The study aimed to compare the left atrial voltage between SR and AF in association with the electrogram waveform. METHODS: This prospective observational study included 30 consecutive patients with persistent AF. After completion of PV isolation, electrogram points were taken during both SR and AF at the identical locations evenly throughout the left atrium. Electrograms were divided into two types: normal (sharp electrogram with ≤3 peaks or duration 3 peaks and duration ≥50 ms). RESULTS: . In a total of 1,063 point pairs, 135 (13%) demonstrated a fractionated electrogram during SR and 483 (45%) during AF. The locations with fractionated electrograms during AF more frequently showed fractionation during SR compared to those with normal electrograms during AF (23% vs 5%, P < 0.0001), and had lower amplitude during SR (1.47 ± 1.29 mV vs 2.03 ± 1.19 mV, P < 0.0001). Electrogram amplitude was higher during SR than that during AF (1.77 ± 1.27 mV vs 0.96 ± 0.77 mV, P < 0.0001) with a weak correlation (r = 0.56, P < 0.0001). Subgroup analyses revealed that the correlation was relatively strong (r = 0.73, P < 0.0001) among the electrogram amplitudes with normal waveform during SR and AF. CONCLUSIONS: Significant differences in electrogram voltage and fractionation degree may exist between SR and AF at the same locations in patients with persistent AF.
Masuda et al. (Fri,) conducted a observational in Persistent atrial fibrillation (n=30). Electrogram mapping during atrial fibrillation vs. Electrogram mapping during sinus rhythm was evaluated on Electrogram amplitude (p=< 0.0001). In patients with persistent AF, electrogram amplitude was significantly lower during AF compared to sinus rhythm (0.96 ± 0.77 mV vs 1.77 ± 1.27 mV, P < 0.0001).