Electroanatomic mapping of right atrial activation in patients with and without paroxysmal atrial fibrillation

Atrial average conduction velocity in patients with and without paroxysmal atrial fibrillation

“…To avoid the limitation that the CARTO system uses direct linear distance between sites in calculating the CV, Luo et al . calculated the atrial CV by summing up the lengths of a series short straight linear distances (Luo et al ., ). In the current study, we tried to avoid measuring the distance between two remote sites and limited the distance of the paired measurement sites to ≤30 mm (Luo et al ., ).…”

“…In previous studies, intra‐atrial and interatrial conduction times between remote sites were used to evaluate conduction disturbance (Platonov et al ., ; Luo et al ., ; Xia et al ., ). The accuracy of these evaluations was therefore limited by interindividual variations in measurement sites, sizes and morphologies of the atrium.…”

“…The role of intra‐atrial conduction disturbance in the development of AF is less clear (Papageorgiou et al ., ). We have earlier tried to evaluate conduction velocity (CV), instead of conduction time, using our data from electroanatomic mapping (CARTO mapping system, Biosense, Waterloo, Belgium) of the right atrium to minimize the influence of interindividual variations in distances between measurement sites (Luo et al ., ). In that study, no difference in CV of the right atrium was found between patients with paroxysmal AF and with atrioventricular nodal re‐entrant tachycardia (AVNRT).…”

Age‐Related Changes in Human Left and Right Atrial Conduction

“…Although catheter‐based three‐dimensional location systems have enabled accurate location of electrodes providing the basis for different methods for calculating CV, unless the direction of wavefront propagation is taken in consideration, assumed CV measurements will always tend to overestimate the true velocity and dispersion of conduction 6,10–15 . These studies have found atrial CVs from 48 cm/sec up to 250 cm/sec compared with the much narrower range of 60–115 cm/sec with epicardial mapping, albeit limited by the inability to access all parts of the atria in anaesthetized open‐chested humans.…”

“…Previous studies measuring WPV by dividing the distance by the activation interval between two points not necessarily in line with the direction of wavefront propagation would overestimate the true velocity and introduce artefactual variation in the data. Accordingly, measurements of WPV from previous studies with endocardial mapping techniques have tended to show exaggerated CVs (up to twofold) and greater variances (up to threefold), compared with studies using simultaneous multielectrode intraoperative epicardial mapping in which the direction of wavefront propagation can be taken into account but which are subject to the limitations of studying limited areas of atrial free wall in the anesthetized patient 6,10–15 . Unlike previous studies investigating endocardial CV, we validated an algorithm that incorporated the local vector of activation to measure WPV in the direction of wavefront propagation from three‐dimensional electroanatomical maps to test the hypothesis that there are age‐related alterations in WPV in both atria.…”