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J Cardiovasc Electrophysiol. 2022 Apr 19. doi: 10.1111/jce.15498. Online ahead of print.

INTRODUCTION: Areas displaying reduced bipolar voltage are defined as low-voltage areas (LVAs). Moreover, left atrial (LA) LVAs after pulmonary vein isolation (PVI) have been reported as a predictor of recurrent atrial fibrillation (AF). In this study, we compared grid mapping catheter (GMC) with PentaRay catheter (PC) for LA voltage mapping on Ensite Precision mapping system.

METHODS: Twenty-six consecutive patients with LVAs and border zone within the LA were enrolled. After achieving PVI, voltage mapping under high right atrial pacing for 600msec was performed twice using each catheter type (GMC first, PC next). Furthermore, LVA was defined as a region with a bipolar voltage of <0.50, and border zone was defined as a region with a bipolar voltage of <1.0, or <1.5 mV.

RESULTS: Compared with PC, using GMC, voltage mapping contained more mapping points (20242ï¼»15859, 26013ï¼½ vs 5589ï¼»4088,7649ï¼½; P < .0001), and more mapping points per minute(1428ï¼»1275, 1803ï¼½ vs 558ï¼»372,783ï¼½; P < .0001). In addition, LVA and border zone size using GMC was significantly less than that reported using PC: <1.0 mV (5.9 cm2 ï¼»2.9, 20.2ï¼½ vs. 13.9 cm2 ï¼»6.3, 24.1ï¼½, P = 0.018) and <1.5mV voltage cutoff (10.6 cm2 ï¼»6.6, 27.2ï¼½ vs. 21.6 cm2 ï¼»12.6, 35.0ï¼½, P = 0.005).

CONCLUSION: Bipolar voltage amplitude estimated by GMC was significantly larger than that estimated by PC on Ensite Precision mapping system. GMC may be able to find highly selective identification of LVAs with lower prevalence and smaller LVA and border zone size. This article is protected by copyright. All rights reserved.