Arrhythmias & electrophysiologyMechanistic study
Functional mapping to reveal slow conduction and substrate progression in atrial fibrillation
- Mechanistic study
- consecutive patients
Authors' conclusion
Functional mapping identifies more discrete and reproducible abnormal substrates than mapping during AF. The HSC+ sites in response to triple extrastimuli are more frequent in persistent AF than in paroxysmal AF.
Study context
- Population
- Patients with paroxysmal or persistent atrial fibrillation (AF) undergoing first pulmonary vein isolation10:10
- Participants
- 20 patients
- Comparison
- Persistent AF vs Paroxysmal AF
- Persistent AFn = 10
- Paroxysmal AFn = 10reference
- Outcome
- Areas of hidden slow conduction (HSC) in response to short-coupled atrial extrastimuli and their relationship with AF phenotype
Main finding
As reported in the abstract
HSC+ sites
P < 0.001
Further findings
| Outcome | Values | P value |
|---|---|---|
| Delta of bipolar EGM duration | HSC+ 53 ± 22 ms · HSC- 13 ± 11 ms | P < 0.001 |
| Number of HSC+ vs CFAE sites during AF | HSC+ 19 per map · CFAE 56 per map | P < 0.001 |
| Bipolar voltage in preceding sinus beat | Negative 1.65 ± 1.34 mV · Positive 1.48 ± 1.47 mV | P = 0.12 |
- Delta of bipolar electrograms (EGM) duration: HSC (HSC-) printed as 13 ± 11 (10) ms
Reproducibility and distribution in repeated maps
- Hidden slow conduction (HSC)+ superior to complex fractionated atrial EGMs (CFAE) (HSC+ P = 0.19 vs CFAE P < 0.001)
Bipolar voltage in preceding sinus beat
- Similar bipolar voltage at sites with negative and positive responses
Original publication
Functional mapping to reveal slow conduction and substrate progression in atrial fibrillation. Europace. Published 14 November 2023. doi:10.1093/europace/euad246
Summarised from the published abstract; every number is checked against it