Arrhythmias & electrophysiology
Identification of Critical Slowing of Conduction Using Unipolar Atrial Voltage and Fractionation Mapping
Authors' conclusion
Sites with fractionated, low-voltage potentials have substantially slower local CV compared with sites with either low-voltage, nonfractionated potentials or fractionated, high-voltage potentials. However, the strong inverse relationship between the positive predictive value and sensitivity of a combined voltage and fractionation threshold for slowed conduction is likely to complicate the use of these signal-based ablation approaches in AF patients.
Study context
- Population
- Patients undergoing intraoperative epicardial mapping during sinus rhythm
- Participants
- 319 patients
- Comparison
- Local conduction velocity at sites with fractionated and/or low-voltage unipolar potentials
- Outcome
- Local CV at sites with fractionated and/or low-voltage potentials
Methodological detailsintraoperative epicardial mapping, sinus rhythm
- Intraoperative epicardial mapping
- Sinus rhythm
Main finding
As reported in the abstract
Local CV
P < 0.001
Further findings
- Prevalence of fractionated, low-voltage potentials (% of atrial sites)
- 0.36% · IQR 0.15%–0.78%
Identification of slow conduction (conduction velocity (CV) <50 cm/s) by <1 mV and ≥3 deflections
- PPV
- 54.2%-70.7%
- Sensitivity
- 0.1%-1.9%
Original publication
Identification of Critical Slowing of Conduction Using Unipolar Atrial Voltage and Fractionation Mapping. JACC Clin Electrophysiol. Published 17 July 2024. doi:10.
Summarised from the published abstract; every number is checked against it