BACKGROUND: Regional differences in fibrosis, particularly related to the posterior wall and septum, may be important in atrial fibrillation (AF). Using electroanatomic mapping, voltage can be used as a measure of fibrosis. OBJECTIVES: The purpose of this study was to determine if patients with AF have disproportionately lower voltage in the septal and posterior walls of the left atrium. METHODS: Sinus rhythm left atrial electroanatomic maps were used in serial patients presenting for left atrial ablation of AF (8-mm tip). Patients undergoing left atrial mapping for focal atrial tachycardia (AT) were used as a comparison group (4-mm tip). Animal experiments were performed to assess the influence of ablation catheter tip size on voltage amplitude. RESULTS: The posterior and septal walls exhibited the lowest voltages in both groups. Compared with the anterior wall, there was a 3.78-fold greater odds of finding a low-voltage point (<0.5 mV) in the septum (P <.001) and a 3.37-fold greater odds of finding a low-voltage point in the posterior wall (P <.001) in the AF patients; the proportion of low-voltage points by region were not significantly different in the AT group. In the animal model, the mean voltage obtained from an 8-mm ablation catheter was significantly higher (0.30 +/- 0.17 mV) than that obtained from the same points using a 4-mm catheter (0.22 +/- 0.17, P = .05). CONCLUSION: Regional differences in voltage are present in patients with atrial arrhythmias, with AF patients exhibiting significantly more low-voltage areas in the septum and posterior walls.
BACKGROUND: Regional differences in fibrosis, particularly related to the posterior wall and septum, may be important in atrial fibrillation (AF). Using electroanatomic mapping, voltage can be used as a measure of fibrosis. OBJECTIVES: The purpose of this study was to determine if patients with AF have disproportionately lower voltage in the septal and posterior walls of the left atrium. METHODS: Sinus rhythm left atrial electroanatomic maps were used in serial patients presenting for left atrial ablation of AF (8-mm tip). Patients undergoing left atrial mapping for focal atrial tachycardia (AT) were used as a comparison group (4-mm tip). Animal experiments were performed to assess the influence of ablation catheter tip size on voltage amplitude. RESULTS: The posterior and septal walls exhibited the lowest voltages in both groups. Compared with the anterior wall, there was a 3.78-fold greater odds of finding a low-voltage point (<0.5 mV) in the septum (P <.001) and a 3.37-fold greater odds of finding a low-voltage point in the posterior wall (P <.001) in the AFpatients; the proportion of low-voltage points by region were not significantly different in the AT group. In the animal model, the mean voltage obtained from an 8-mm ablation catheter was significantly higher (0.30 +/- 0.17 mV) than that obtained from the same points using a 4-mm catheter (0.22 +/- 0.17, P = .05). CONCLUSION: Regional differences in voltage are present in patients with atrial arrhythmias, with AFpatients exhibiting significantly more low-voltage areas in the septum and posterior walls.
Authors: Hakan Oral; Christoph Scharf; Aman Chugh; Burr Hall; Peter Cheung; Eric Good; Srikar Veerareddy; Frank Pelosi; Fred Morady Journal: Circulation Date: 2003-10-13 Impact factor: 29.690
Authors: Nassir F Marrouche; Thomas Dresing; Christopher Cole; Dianna Bash; Eduardo Saad; Krzysztof Balaban; Stephen V Pavia; Robert Schweikert; Walid Saliba; Ahmed Abdul-Karim; Ennio Pisano; Raffaele Fanelli; Patrick Tchou; Andrea Natale Journal: J Am Coll Cardiol Date: 2002-08-07 Impact factor: 24.094
Authors: Prashanthan Sanders; Joseph B Morton; Peter M Kistler; Steven J Spence; Neil C Davidson; Azlan Hussin; Jitendra K Vohra; Paul B Sparks; Jonathan M Kalman Journal: Circulation Date: 2004-03-08 Impact factor: 29.690
Authors: Peter M Kistler; Prashanthan Sanders; Simon P Fynn; Irene H Stevenson; Steven J Spence; Jitendra K Vohra; Paul B Sparks; Jonathan M Kalman Journal: J Am Coll Cardiol Date: 2004-07-07 Impact factor: 24.094
Authors: Prashanthan Sanders; Joseph B Morton; Neil C Davidson; Steven J Spence; Jitendra K Vohra; Paul B Sparks; Jonathan M Kalman Journal: Circulation Date: 2003-09-02 Impact factor: 29.690
Authors: Gautam G Lalani; Amir Schricker; Michael Gibson; Armand Rostamian; David E Krummen; Sanjiv M Narayan Journal: J Am Coll Cardiol Date: 2012-02-07 Impact factor: 24.094
Authors: Dolkun Rahmutula; Gregory M Marcus; Emily E Wilson; Chun-Hua Ding; Yuanyuan Xiao; Agnes C Paquet; Rebecca Barbeau; Andrea J Barczak; David J Erle; Jeffrey E Olgin Journal: Cardiovasc Res Date: 2013-04-23 Impact factor: 10.787
Authors: Gregory M Marcus; Mary A Whooley; David V Glidden; Ludmila Pawlikowska; Jonathan G Zaroff; Jeffrey E Olgin Journal: Am Heart J Date: 2007-10-25 Impact factor: 4.749