Unipolar atrial electrogram morphology is affected by age: evidence from high-resolution epicardial mapping

Area of Science:

• Cardiology
• Electrophysiology
• Gerontology

Background:

• The impact of aging on unipolar atrial electrogram (U-AEGM) morphology remains unclear.
• It is unknown if age-related U-AEGM changes differ between the right and left atria.

Purpose of the Study:

• To investigate how aging affects U-AEGM morphology.
• To determine if age-related U-AEGM changes are localized to specific atrial regions, particularly Bachmann's bundle (BB).

Main Methods:

• Epicardial high-resolution mapping was conducted in 213 patients during sinus rhythm.
• Patients were grouped into young (age < 60) and aged (age ≥ 60).
• U-AEGMs were classified as single potentials (SPs), short double potentials (SDPs), long double potentials (LDPs), and fractionated potentials (FPs).

Main Results:

• Older age was associated with a significant increase in SDPs, LDPs, and FPs at Bachmann's bundle (BB).
• Conversely, the proportion of SPs decreased at BB in older individuals.
• These age-related changes in U-AEGM morphology were most pronounced at BB.

Conclusions:

• Aging preferentially alters U-AEGM morphology at Bachmann's bundle (BB).
• Increased complex potentials (SDPs, LDPs, FPs) at BB reflect aggravated conduction abnormalities with age.
• BB's altered electrograms in aging may contribute to age-related arrhythmias like atrial fibrillation.