Introduction
Atrial fibrosis is the most important predictor of arrhythmia recurrence
following pulmonary vein (PV) isolation and is a marker of AF
persistence and progression. [1] Despite the importance of this
there is no common consensus on the optimal method of visualizing
fibrosis. Delayed enhanced magnetic resonance imaging often lacks
adequate resolution and has a significant potential for artefact.
[2] Although high density bipolar voltage mapping during sinus
rhythm (SR) may be considered a surrogate for the presence of fibrosis
[3] there are many potential factors which may influence these
recordings including wavefront dynamics, electrode orientation, spacing
and size. [4] Importantly many patient who attend for catheter
ablation for AF are not in SR at the time of the procedure and there is
no clear correlation between substrate mapping during either arrhythmia.
Voltage recordings during AF (AFv) are calculated as the maximum peak to
peak within a window of interest and vary significantly from voltage
recordings made during sinus rhythm (SRv).
The objective of our study was to assess whether there is a clear
relationship between the mean AFv recorded over various durations and
the SRv.