Comparison of voltages between atria: differences in sinus rhythm and atrial fibrillation

Abstract

Background: ultra high-density mapping systems allow for comparison of atrial electroanatomical maps in unprecedented detail. Atrial scar determined by voltages and surface area between atria, rhythm and atrial fibrillation (AF) types was assessed.

Methods: left (LA) and right atrial (RA) maps were created using Rhythmia HDx in patients listed for ablation for paroxysmal (PAF, sinus rhythm (SR) maps only) or persistent AF (PeAF, AF and SR maps). Electrograms on corresponding SR/AF maps were paired for direct comparison. Percentage surface area of scar was assigned low- (LVM, ≤ 0.05 mV), intermediate- (IVM, 0.05–0.5 mV) or normal voltage myocardium, (NVM, > 0.5 mV).

Results: thirty-eight patients were recruited generating 96 maps using 913,480 electrograms. Paired SR-AF bipolar electrograms showed fair correlation in LA (Spearman’s ρ = 0.32) and weak correlation in RA (ρ = 0.19) and were significantly higher in SR in both (LA: 0.61 mV (0.20–1.67) vs 0.31 mV (0.10–0.74), RA: 0.68 mV (0.19–1.88) vs 0.47 mV (0.14–1.07), p 
Significantly more IVM/LVM surface areas were seen in AF over SR (LA only, p 
Conclusions: ultra high-density mapping shows paired electrograms correlate poorly between SR and AF. SR electrograms are typically (but not always) larger than those in AF. Patients with PeAF have a lower global electrogram voltage than those with PAF. Electrogram voltages are similar between atria within individual patients.

More information

Identifiers

Catalogue record

Export record

Altmetrics