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Comparison of Unipolar and Bipolar Voltage Mapping for Localization of Left Atrial Arrhythmogenic Substrate in Patients With Atrial Fibrillation

Nairn, Deborah 1; Lehrmann, Heiko; Müller-Edenborn, Björn; Schuler, Steffen 1; Arentz, Thomas; Dössel, Olaf 1; Jadidi, Amir; Loewe, Axel ORCID iD icon 1
1 Institut für Biomedizinische Technik (IBT), Karlsruher Institut für Technologie (KIT)


Background: Presence of left atrial low voltage substrate in bipolar voltage mapping is associated with increased arrhythmia recurrences following pulmonary vein isolation for atrial fibrillation (AF). Besides local myocardial fibrosis, bipolar voltage amplitudes may be influenced by inter-electrode spacing and bipole-to-wavefront-angle. It is unclear to what extent these impact low voltage areas (LVA) in the clinical setting. Alternatively, unipolar electrogram voltage is not affected by these factors but requires advanced filtering.

Objectives: To assess the relationship between bipolar and unipolar voltage mapping in sinus rhythm (SR) and AF and identify if the electrogram recording mode affects the quantification and localization of LVA.

Methods: Patients (n = 28, 66±7 years, 46% male, 82% persistent AF, 32% redo-procedures) underwent high-density (>1,200 sites, 20 ± 10 sites/cm2, using a 20-pole 2-6-2 mm-spaced Lasso) voltage mapping in SR and AF. Bipolar LVA were defined using four different thresholds described in literature: <0.5 and <1 mV in SR, <0.35 and <0.5 mV in AF. The optimal unipolar voltage threshold resulting in the highest agreement in both unipolar and bipolar mapping modes was determined. ... mehr

Verlagsausgabe §
DOI: 10.5445/IR/1000129742
Veröffentlicht am 16.02.2021
DOI: 10.3389/fphys.2020.575846
Zitationen: 16
Web of Science
Zitationen: 16
Zitationen: 20
Cover der Publikation
Zugehörige Institution(en) am KIT Institut für Biomedizinische Technik (IBT)
Publikationstyp Zeitschriftenaufsatz
Publikationsjahr 2020
Sprache Englisch
Identifikator ISSN: 1664-042X
KITopen-ID: 1000129742
Erschienen in Frontiers in physiology
Verlag Frontiers Media SA
Band 11
Vorab online veröffentlicht am 26.11.2020
Nachgewiesen in Dimensions
Web of Science
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