Does the extent of left atrial arrhythmogenic substrate depend on the electroanatomical mapping technique: impact of pulmonary vein mapping catheter vs. ablation catheter

In persistent atrial fibrillation (AF), left atrial low-voltage areas and complex fractionated atrial electrograms (CFAEs) have been thoroughly discussed as critical substrate points for AF perpetuation. Thus, in patients undergoing pulmonary vein isolation, these sites are often considered addition...

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Bibliographic Details
Published in:Europace (London, England) England), 2017-08, Vol.19 (8), p.1293-1301
Main Authors: Huemer, Martin, Qaiyumi, Daniel, Attanasio, Philipp, Parwani, Abdul, Pieske, Burkert, Blaschke, Florian, Boldt, Leif-Hendrik, Haverkamp, Wilhelm, Wutzler, Alexander
Format: Article
Language:English
Subjects:
Action Potentials
Aged
Atrial Fibrillation - diagnosis
Atrial Fibrillation - physiopathology
Atrial Fibrillation - surgery
Cardiac Catheterization - instrumentation
Cardiac Catheters
Catheter Ablation - instrumentation
Electrophysiologic Techniques, Cardiac - instrumentation
Equipment Design
Female
Heart Rate
Humans
Male
Middle Aged
Predictive Value of Tests
Prospective Studies
Pulmonary Veins - physiopathology
Pulmonary Veins - surgery
Reproducibility of Results
Signal Processing, Computer-Assisted
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Summary:In persistent atrial fibrillation (AF), left atrial low-voltage areas and complex fractionated atrial electrograms (CFAEs) have been thoroughly discussed as critical substrate points for AF perpetuation. Thus, in patients undergoing pulmonary vein isolation, these sites are often considered additional ablation targets. Currently, mapping techniques for these substrate indicators are still under discussion. The aim of this study was to evaluate the impact of different mapping catheters on the detection of low-voltage areas and CFAE. Two bipolar voltage maps and two CFAE left atrial maps were obtained each in 30 patients undergoing catheter ablation of AF using the following two different catheters: A four-pole ablation catheter (MAP, mapping and ablation catheter) (electrode size: tip: 4 mm, band: 1 mm; inter-electrode spacing: 0.5-5-2 mm) and a 10-pole circular pulmonary vein mapping catheter (CMC) (electrode size: 1 mm; inter-electrode spacing: 7-7-7 mm). Successively, low-voltage and CFAE area sizes were then compared between the two catheters. Areas with a bipolar voltage of
ISSN:1099-5129
1532-2092
DOI:10.1093/europace/euw185