ArticleJournal of cardiovascular electrophysiology2026
Substrate Unmasking via High-Density Omnipolar Mapping Under Rapid Pacing in Atrial Fibrillation.
Article in Journal of cardiovascular electrophysiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Substrate Unmasking via High-Density Omnipolar Mapping Under Rapid Pacing in Atrial Fibrillation.Journal of cardiovascular electrophysiology · 2026Article
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Authors and funding
9 authors.
Funding
Abstract
backgroundSubstrate mapping for atrial fibrillation (AF) ablation commonly relies on sinus rhythm (SR) maps, which may overlook rate-dependent electrophysiological changes.
objectiveThis study aimed to evaluate the diagnostic and prognostic value of rate-dependent substrate characterization using high-density omnipolar mapping under rapid pacing.
methodsIn a prospective cohort of 46 patients (5 controls, 22 paroxysmal AF [PAF], 19 persistent AF [PeAF]), bi-atrial conduction velocity (CV) and low-voltage zones (LVZ) were assessed across seven mapping conditions: SR and graded pacing (600, 400, 300 ms) from the distal coronary sinus (CSD) and high right atrium (HRA).
resultsCV decreased with faster pacing across all cohorts. At 300 ms, PeAF patients exhibited significantly slower CV than PAF and controls (0.60 ± 0.07 vs. 0.72 ± 0.06 vs. 0.90 ± 0.05 m/s; p < 0.001). The global LVZ burden was greater in PeAF than PAF at 300 ms (58.71 [39.84-68.69] vs. 26.18 [20.94-37.40]; p = 0.009). Decremental pacing was associated with progressive bi-atrial conduction slowing in AF, most pronounced in PeAF (0.76 ± 0.08 vs. 0.74 ± 0.06 vs. 0.69 ± 0.02 vs. 0.60 ± 0.07 m/s; p < 0.001). Rapid pacing at 300 ms showed the numerically highest discriminative capacity. Patients with global CV < 0.67 m/s (AUC 0.749; p = 0.019) or LVZ% > 43.4% (AUC 0.681; p = 0.008) at 300 ms were associated with a higher risk of recurrence.
conclusionRapid pacing at 300 ms reveals latent bi-atrial substrate occult during SR and may improve risk stratification.
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