PMID- 31165967
OWN - NLM
STAT- MEDLINE
DCOM- 20210818
LR  - 20210818
IS  - 1572-8595 (Electronic)
IS  - 1383-875X (Linking)
VI  - 59
IP  - 1
DP  - 2020 Oct
TI  - Quantitative assessment of left atrial scar using high-density voltage mapping 
      and a novel automated voltage analysis tool.
PG  - 5-12
LID - 10.1007/s10840-019-00570-7 [doi]
AB  - PURPOSE: Left atrial (LA) fibrosis plays an important role in the pathogenesis 
      and perpetuation of atrial fibrillation (AF). It may be identified by bipolar 
      voltage (BiV) mapping, but quantification of fibrosis which previously relied on 
      visual estimation of scar has been shown to be inaccurate. Our aim was to use a 
      novel automated voltage histogram analysis (VHA) tool to quantify LA scar burden 
      accurately in patients with AF. METHODS: LA voltage was assessed in 100 
      consecutive patients undergoing first pulmonary vein isolation (PVI) for 
      paroxysmal or persistent AF using a circular multielectrode catheter to create 
      high-density LA BiV maps which were analysed using the VHA tool after the 
      procedure. RESULTS: High-density electro-anatomic maps took 10 min to create and 
      contained a median of 1049 points. The VHA algorithm accurately quantified the 
      burden of Diseased LA Tissue (</= 0.5 mV) and Dense LA Scar (</= 0.2 mV) with a 
      median of 17.8% and 3.5% respectively. A quartile classification was applied 
      based on diseased LA tissue burden. Patients in class IV with the highest 
      diseased LA burden were older (p < 0.0001), more likely female (p = 0.0095), had 
      higher CHA(2)DS(2)-VASc scores (p = 0.0024) and were more likely to have 
      persistent rather than paroxysmal AF (p = 0.0179) than those in classes I-III. 
      CONCLUSIONS: The VHA algorithm is able to quantify percentage surface area 
      voltage rapidly and according to preset ranges for the first time. The algorithm 
      offers the potential for classification of patients undergoing AF ablation into 
      different classes of diseased LA burden, which may have diagnostic, therapeutic 
      and prognostic implications.
FAU - Herczeg, Szilvia
AU  - Herczeg S
AD  - Heart and Vascular Center, Semmelweis University, 68 Varosmajor Street, Budapest, 
      1122, Hungary.
FAU - Walsh, Katie
AU  - Walsh K
AD  - Heart and Vascular Centre, Mater Private Hospital, Eccles Street, Dublin 7, 
      Ireland.
FAU - Keaney, John J
AU  - Keaney JJ
AD  - Heart and Vascular Centre, Mater Private Hospital, Eccles Street, Dublin 7, 
      Ireland.
FAU - Keelan, Edward
AU  - Keelan E
AD  - Heart and Vascular Centre, Mater Private Hospital, Eccles Street, Dublin 7, 
      Ireland.
FAU - Travers, John
AU  - Travers J
AD  - Heart and Vascular Centre, Mater Private Hospital, Eccles Street, Dublin 7, 
      Ireland.
FAU - Szeplaki, Gabor
AU  - Szeplaki G
AD  - Heart and Vascular Centre, Mater Private Hospital, Eccles Street, Dublin 7, 
      Ireland.
FAU - Galvin, Joseph
AU  - Galvin J
AUID- ORCID: 0000-0002-3617-8738
AD  - Heart and Vascular Centre, Mater Private Hospital, Eccles Street, Dublin 7, 
      Ireland. jgalvin@materprivate.ie.
LA  - eng
PT  - Journal Article
DEP - 20190605
PL  - Netherlands
TA  - J Interv Card Electrophysiol
JT  - Journal of interventional cardiac electrophysiology : an international journal of 
      arrhythmias and pacing
JID - 9708966
SB  - IM
MH  - *Atrial Fibrillation/diagnostic imaging/pathology/surgery
MH  - *Catheter Ablation
MH  - Cicatrix/pathology
MH  - Female
MH  - Heart Atria/surgery
MH  - Humans
MH  - *Pulmonary Veins/diagnostic imaging/surgery
OTO - NOTNLM
OT  - Atrial fibrillation
OT  - Electroanatomical mapping
OT  - Fibrosis
OT  - Pulmonary vein isolation
OT  - Scar
OT  - Voltage mapping
EDAT- 2019/06/06 06:00
MHDA- 2021/08/19 06:00
CRDT- 2019/06/06 06:00
PHST- 2019/01/27 00:00 [received]
PHST- 2019/05/19 00:00 [accepted]
PHST- 2019/06/06 06:00 [pubmed]
PHST- 2021/08/19 06:00 [medline]
PHST- 2019/06/06 06:00 [entrez]
AID - 10.1007/s10840-019-00570-7 [pii]
AID - 10.1007/s10840-019-00570-7 [doi]
PST - ppublish
SO  - J Interv Card Electrophysiol. 2020 Oct;59(1):5-12. doi: 
      10.1007/s10840-019-00570-7. Epub 2019 Jun 5.