Sinus rhythm voltage fingerprinting in patients with mitral valve disease using a high-density epicardial mapping approach.
Europace
; 23(3): 469-478, 2021 03 08.
Article
em En
| MEDLINE
| ID: mdl-33432326
ABSTRACT
AIMS:
Unipolar voltage (UV) mapping is increasingly used for guiding ablative therapy of atrial fibrillation (AF) as unipolar electrograms (U-EGMs) are independent of electrode orientation and atrial wavefront direction. This study was aimed at constructing individual, high-resolution sinus rhythm (SR) UV fingerprints to identify low-voltage areas and study the effect of AF episodes in patients with mitral valve disease (MVD). METHODS ANDRESULTS:
Intra-operative epicardial mapping (interelectrode distance 2 mm) of the right and left atrium, Bachmann's bundle (BB), and pulmonary vein area was performed in 67 patients (27 male, 67 ± 11 years) with or without a history of paroxysmal AF (PAF). In all patients, there were considerable regional variations in voltages. UVs at BB were lower in patients with PAF compared with those without [no AF 4.94 (3.56-5.98) mV, PAF 3.30 (2.25-4.57) mV, P = 0.006]. A larger number of low-voltage potentials were recorded at BB in the PAF group [no AF 2.13 (0.52-7.68) %, PAF 12.86 (3.18-23.59) %, P = 0.001]. In addition, areas with low-voltage potentials were present in all patients, yet we did not find any predilection sites for low-voltage potentials to occur.CONCLUSION:
Even in SR, advanced atrial remodelling in MVD patients shows marked inter-individual and regional variation. Low UVs are even present during SR in patients without a history of AF indicating that low UVs should carefully be used as target sites for ablative therapy.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Doenças das Valvas Cardíacas
Tipo de estudo:
Diagnostic_studies
/
Prognostic_studies
Limite:
Humans
/
Male
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article