Comparison of Left Atrial Bipolar Voltage and Scar Using Multielectrode Fast Automated Mapping versus Point-by-Point Contact Electroanatomic Mapping in Patients With Atrial Fibrillation Undergoing Repeat Ablation

Introduction : Bipolar voltage criteria to delineate LA scar have been derived using PBP contact electroanatomical mapping. It remains unclear how PBP-derived LA scar correlates with ME-FAM derived scar. We aimed to correlate scar and bipolar voltages from left atrial (LA) maps created using point-by-point (PBP) versus multi-electrode fast automated mapping (ME-FAM). Methods and Results : In consecutive patients undergoing repeat AF ablation, 2 separate LA maps were created using PBP and ME-FAM during sinus rhythm before ablation. Contiguous areas in the LA with a bipolar voltage cutoff of ≤0.2 mV represented dense scar; LA scar percentage was calculated for each map. Each LA shell was divided into 9 regions and each region further subdivided into 4 quadrants for additional analysis; mean voltages of all points obtained using PBP versus ME-FAM in each region were compared. Forty maps (20 PBP: mean 228.5±95.6 points; 20 ME-FAM: 923.0±382.6 points) were created in 20 patients. Mapping time with ME-FAM was shorter compared with PBP (13.3±5.3 vs. 34.4±13.1 minutes; p 0.05). Conclusions : In AF patients undergoing repeat ablation, bipolar voltage is greater in certain LA segments with ME-FAM compared with PBP mapping. This article is protected by copyright. All rights reserved