Journal
HEART RHYTHM
Volume 13, Issue 4, Pages 870-878Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.hrthm.2015.12.029
Keywords
Atrial fibrillation; Atrial tachycardia; Inducibility; Substrate; Low-voltage area
Categories
Ask authors/readers for more resources
BACKGROUND Recurrent atrial tachyarrhythmias occur as a result of residual atrial arrhythmogenic substrates after atrial fibrillation (AF) ablation. In patients with AF, electrograms with reduced amplitudes indicate diseased myocardium. OBJECTIVE The purpose of this study was to investigate the association between the distribution of low-voltage areas and the type of induced atrial tachyarrhythmias. METHODS Our prospective observational study enrolled 152 consecutive AF patients scheduled for an initial ablation (46% persistent AF). After pulmonary vein isolation, voltage mapping was performed during sinus rhythm, and regions with reduced electrogram amplitudes (<0.5 mV) were defined as low-voltage areas. Burst pacing was performed to investigate the inducibility of atrial tachyarrhythmias. RESULTS Low-voltage areas were more frequently observed in patients with persistent AF than paroxysmal AF (50% vs 34%, P=.048). A higher proportion of patients with low-voltage areas presented with inducibility of atrial tachyarrhythmias than those without, as follows: AF 70% vs 16% (P=.0001); perimitral macroreentrant atrial tachycardia (AT) 18% vs 00/0 (P=.0001); and roof-dependent macroreentrant AT 13% vs 00/0 (P=.01). Investigation into the regional distribution of low-voltage areas revealed that patients with perimitral macroreentrant AT more frequently coincided with low-voltage areas than those without in the septal (100% vs 18%, P<.0001) and anterior regions (55% vs 11%, P=.001), and those with roof -dependent AT in the roof (75% vs 15%, P<.0001) and posterior regions (75% vs 15%, P=.0001). CONCLUSION Low -voltage areas are associated with high inducibility of atrial tachyarrhythmias after pulmonary vein isolation. In addition, the distribution of low -voltage areas is specific for each type of macroreentrant AT.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available