ArticlePacing and clinical electrophysiology : PACE2026
Atrial Substrate Progression in AF Patients: Insights From Unipolar Mapping.
Article in Pacing and clinical electrophysiology : PACE, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAtrial substrate progression is common among patients with atrial fibrillation (AF). Unipolar voltage mapping more comprehensively characterizes the atrial substrate compared with bipolar mapping.
objectiveThis study aimed to characterize atrial substrate progression in patients with recurrent AF using unipolar mapping after pulmonary vein isolation.
methodsIn this single-center retrospective study, consecutive AF patients undergoing index and redo ablations were enrolled. Electroanatomic maps from both ablations were compared and assessed by unipolar and bipolar voltage. Low-voltage zone (LVZ) was defined as bipolar voltage <0.5 mV or unipolar voltage <1.6 mV. Patients were categorized into progression (n = 35) and nonprogression (n = 15) groups.
resultsA total of 50 patients (mean age 59.5 ± 12.6 years; 40 males) were enrolled. Compared with index ablation, redo ablation demonstrated significantly larger bipolar LVZ (Bi-LVZ) total area (21.25 vs. 15.86 cm
conclusionUni-LVZ characterizes the atrial substrate progression, with the higher Uni/Bi ratio during index ablation indicates greater Bi-LVZ expansion at redo ablation.
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