Arrhythmias & electrophysiology
High-resolution mapping of reentrant atrial tachycardias: Relevance of low bipolar voltage
Authors' conclusion
Widely used bipolar voltage amplitude thresholds to define "abnormal" and "scar" tissue in the atria are, respectively, sensitive and specific for identifying regions of slow conduction during reentrant ATs. However, overall, the association of voltage with CV is modest.
Study context
- Population
- Reentrant atrial tachycardias with bipolar voltage and activation maps30 maps
- Comparison
- Bipolar voltage thresholds for identifying slow conduction
- Outcome
- Diagnostic performance of voltage thresholds for identifying slow conduction (CV <30 cm/s)
Performance
As reported in the abstract
Slow conduction (CV <30 cm/s)
| Strategy | Sensitivity | Specificity |
|---|---|---|
| 0.50 mV threshold | 91% | 35% |
| 0.05 mV threshold | 36% | 87% |
Sensitivity
0.50 mV threshold91%
0.05 mV threshold36%
Specificity
0.50 mV threshold35%
0.05 mV threshold87%
- Bipolar voltage AUC for slow conduction
- 0.733 (95% CI 0.731-0.735)
- Optimal voltage threshold
- 0.15 mV
- Correlation of voltage with conduction velocity (CV)
- r = 0.407; P < .001
Further findings
Analyses restricted to AT circuits
- Weaker associations between voltage and CV; optimal voltage threshold
- 0.25 mV
Determinants of AT circuit dimensions
- No clinical predictors of AT circuit dimensions identified
Original publication
High-resolution mapping of reentrant atrial tachycardias: Relevance of low bipolar voltage. Heart Rhythm. Published 8 November 2022. doi:10.
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