Arrhythmias & electrophysiology
Pacing cycle length–dependent electrophysiologic changes in left atrium: Poor validity of using low-voltage area and slow conduction area under specific pacing cycle length as absolute substrates of atrial fibrillation
Authors' conclusion
LVA and slow conduction area can be emphasized by rapid PCL LA mapping.
Study context
- Population
- Patients undergoing AF ablation, mapped after pulmonary vein isolation
- Participants
- 48 patients
- Comparison
- Rapid pacing cycle length (PCL) vs baseline PCL left atrial (LA) mapping
- Outcome
- PCL-dependent change in LVA (<0.5 mV bipolar voltage), LA activation time, regional mean voltage, regional mean wave propagation velocity and slow conduction area (<0.3 m/s)
Methodological detailspaired LA maps, high-resolution mapping (RHYTHMIA HDx)
- Paired LA maps
- High-resolution mapping (RHYTHMIA HDx)
Main finding
As reported in the abstract
| Group | Total low-voltage area (LVA) | LA activation time |
|---|---|---|
| Rapid PCL | 7.6 ± 9.5 cm² | 87.9 ± 16.2 ms |
| Baseline PCL | 6.7 ± 7.6 cm² | 84.0 ± 14.0 ms |
Total low-voltage area (LVA)
Rapid PCL7.6 ± 9.5 cm²
Baseline PCL6.7 ± 7.6 cm²
LA activation time
Rapid PCL87.9 ± 16.2 ms
Baseline PCL84.0 ± 14.0 ms
- Rapid PCL vs Baseline PCL: P = 0.031 — total LVA
- Rapid PCL vs Baseline PCL: P < 0.0001 — LA activation time
Further findings
Total LVA in patients with a 10 cm² LVA on baseline PCL map (subgroup)
P = 0.013
Original publication
Pacing cycle length–dependent electrophysiologic changes in left atrium: Poor validity of using low-voltage area and slow conduction area under specific pacing cycle length as absolute substrates of atrial fibrillation. Heart Rhythm. Published 19 September 2024. doi:10.
Summarised from the published abstract; every number is checked against it