BACKGROUND: Criteria have not been established for identifying LA scar using electroanatomic mapping (EAM). It is also unclear if voltage criteria using EAM may assist in identifying areas of pulmonary vein (PV) reconnection in patients undergoing repeat AF ablation. OBJECTIVES: To characterize left atrial (LA) voltage in patients undergoing atrial fibrillation (AF) ablation. METHODS: An LA shell was created and bipolar voltage amplitude (in mV) at each point was measured. The shell was divided into 8 regions. Bipolar voltage values lower than the amplitude of 95% of sampled points was used as the upper cutoff value. Delayed enhancement (DE) cardiac magnetic resonance imaging (CMRI) sequences were performed to validate voltage cutoffs. RESULTS: Twenty patients participated. A mean of 141 ± 12 points constituted the LA map that was created during sinus rhythm (SR). In patients undergoing initial AF ablation, mean bipolar LA voltage was 1.44 ± 1.27 mV. In patients undergoing repeat AF ablation, scar along the posterior wall and LA-PV junction was identified using a voltage cutoff <0.2 mV, whereas a cutoff <0.45 mV best identified scar at other locations. This voltage range (0.2-0.45 mV) was useful to identify areas of reconnection around the PVs. On DE CMRI, a bipolar voltage cutoff of 0.27 mV performed best for delineating scar (sensitivity: 90%, specificity: 83%). CONCLUSIONS: In patients undergoing AF ablation, EAM derived LA bipolar voltage shows regional variation. For maps acquired during SR, a voltage range of 0.2-0.45 mV can accurately demarcate LA scar distribution. This can be helpful in identifying PV reconnection in patients undergoing repeat AF ablation.
BACKGROUND: Criteria have not been established for identifying LA scar using electroanatomic mapping (EAM). It is also unclear if voltage criteria using EAM may assist in identifying areas of pulmonary vein (PV) reconnection in patients undergoing repeat AF ablation. OBJECTIVES: To characterize left atrial (LA) voltage in patients undergoing atrial fibrillation (AF) ablation. METHODS: An LA shell was created and bipolar voltage amplitude (in mV) at each point was measured. The shell was divided into 8 regions. Bipolar voltage values lower than the amplitude of 95% of sampled points was used as the upper cutoff value. Delayed enhancement (DE) cardiac magnetic resonance imaging (CMRI) sequences were performed to validate voltage cutoffs. RESULTS: Twenty patients participated. A mean of 141 ± 12 points constituted the LA map that was created during sinus rhythm (SR). In patients undergoing initial AF ablation, mean bipolar LA voltage was 1.44 ± 1.27 mV. In patients undergoing repeat AF ablation, scar along the posterior wall and LA-PV junction was identified using a voltage cutoff <0.2 mV, whereas a cutoff <0.45 mV best identified scar at other locations. This voltage range (0.2-0.45 mV) was useful to identify areas of reconnection around the PVs. On DE CMRI, a bipolar voltage cutoff of 0.27 mV performed best for delineating scar (sensitivity: 90%, specificity: 83%). CONCLUSIONS: In patients undergoing AF ablation, EAM derived LA bipolar voltage shows regional variation. For maps acquired during SR, a voltage range of 0.2-0.45 mV can accurately demarcate LA scar distribution. This can be helpful in identifying PV reconnection in patients undergoing repeat AF ablation.
Authors: Patrick Müller; Johannes Maier; Johannes-Wolfgang Dietrich; Sebastian Barth; Daniel P Griese; Fabian Schiedat; Attila Szöllösi; Philipp Halbfass; Karin Nentwich; Markus Roos; Joachim Krug; Anja Schade; Rainer Schmitt; Andreas Mügge; Thomas Deneke Journal: J Interv Card Electrophysiol Date: 2015-06-06 Impact factor: 1.900
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Heart Rhythm Date: 2017-05-12 Impact factor: 6.343
Authors: Hugh Calkins; Karl Heinz Kuck; Riccardo Cappato; Josep Brugada; A John Camm; Shih-Ann Chen; Harry J G Crijns; Ralph J Damiano; D Wyn Davies; John DiMarco; James Edgerton; Kenneth Ellenbogen; Michael D Ezekowitz; David E Haines; Michel Haissaguerre; Gerhard Hindricks; Yoshito Iesaka; Warren Jackman; José Jalife; Pierre Jais; Jonathan Kalman; David Keane; Young-Hoon Kim; Paulus Kirchhof; George Klein; Hans Kottkamp; Koichiro Kumagai; Bruce D Lindsay; Moussa Mansour; Francis E Marchlinski; Patrick M McCarthy; J Lluis Mont; Fred Morady; Koonlawee Nademanee; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Douglas L Packer; Carlo Pappone; Eric Prystowsky; Antonio Raviele; Vivek Reddy; Jeremy N Ruskin; Richard J Shemin; Hsuan-Ming Tsao; David Wilber Journal: Heart Rhythm Date: 2012-03-01 Impact factor: 6.343
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: Europace Date: 2018-01-01 Impact factor: 5.214
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: J Interv Card Electrophysiol Date: 2017-10 Impact factor: 1.900
Authors: Hugh Calkins; Gerhard Hindricks; Riccardo Cappato; Young-Hoon Kim; Eduardo B Saad; Luis Aguinaga; Joseph G Akar; Vinay Badhwar; Josep Brugada; John Camm; Peng-Sheng Chen; Shih-Ann Chen; Mina K Chung; Jens Cosedis Nielsen; Anne B Curtis; D Wyn Davies; John D Day; André d'Avila; N M S Natasja de Groot; Luigi Di Biase; Mattias Duytschaever; James R Edgerton; Kenneth A Ellenbogen; Patrick T Ellinor; Sabine Ernst; Guilherme Fenelon; Edward P Gerstenfeld; David E Haines; Michel Haissaguerre; Robert H Helm; Elaine Hylek; Warren M Jackman; Jose Jalife; Jonathan M Kalman; Josef Kautzner; Hans Kottkamp; Karl Heinz Kuck; Koichiro Kumagai; Richard Lee; Thorsten Lewalter; Bruce D Lindsay; Laurent Macle; Moussa Mansour; Francis E Marchlinski; Gregory F Michaud; Hiroshi Nakagawa; Andrea Natale; Stanley Nattel; Ken Okumura; Douglas Packer; Evgeny Pokushalov; Matthew R Reynolds; Prashanthan Sanders; Mauricio Scanavacca; Richard Schilling; Claudio Tondo; Hsuan-Ming Tsao; Atul Verma; David J Wilber; Teiichi Yamane Journal: J Arrhythm Date: 2017-09-15