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Related Concept Videos

ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias01:25

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Arrhythmia is a condition characterized by an irregular heart rhythm, with ECG changes that differ based on its origin and nature. The types of arrhythmias discussed below include atrial, junctional, and ventricular arrhythmias.Atrial ArrhythmiasPremature Atrial Complexes (PACs): PACs are early atrial beats caused by stress, caffeine, alcohol, electrolyte imbalances, hypoxia, hyperthyroidism, or certain medications (e.g., bronchodilators and decongestants). The ECG shows early P waves with an...
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Related Experiment Video

Updated: Apr 1, 2026

High-Resolution Endocardial and Epicardial Optical Mapping in a Sheep Model of Stretch-Induced Atrial Fibrillation
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Atrial Substrate Progression in AF Patients: Insights From Unipolar Mapping.

Xiongxin Hu1, Kehui Zhang1, Kexin Wang1

  • 1Department of Cardiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.

Pacing and Clinical Electrophysiology : PACE
|March 31, 2026
PubMed
Summary
This summary is machine-generated.

Unipolar voltage mapping (Uni-LVZ) effectively identifies atrial substrate progression in atrial fibrillation (AF) patients. A higher Uni/Bi ratio during initial ablation predicts greater low-voltage zone expansion during redo procedures.

Keywords:
AF recurrenceatrial fibrillationbipolar voltagecatheter ablationsubstrateunipolar voltage

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Area of Science:

  • Electrophysiology
  • Cardiac Mapping
  • Atrial Fibrillation

Background:

  • Atrial substrate progression is a common finding in patients with atrial fibrillation (AF).
  • Unipolar voltage mapping offers a more comprehensive characterization of the atrial substrate than bipolar mapping.

Purpose of the Study:

  • To characterize atrial substrate progression in patients with recurrent AF.
  • To evaluate the utility of unipolar mapping after pulmonary vein isolation for assessing substrate changes.

Main Methods:

  • A single-center retrospective study included AF patients undergoing index and redo ablations.
  • Electroanatomic maps were analyzed using unipolar and bipolar voltage, defining low-voltage zones (LVZ).
  • Patients were categorized into progression and nonprogression groups based on substrate changes.

Main Results:

  • Redo ablation showed significantly larger bipolar LVZ area and burden compared to index ablation.
  • The progression group exhibited higher LVZ burden and a greater unipolar to bipolar LVZ area ratio (Uni/Bi) during index ablation.
  • A higher index-ablation Uni/Bi ratio positively correlated with the degree of bipolar LVZ area expansion at redo ablation.

Conclusions:

  • Unipolar LVZ mapping effectively characterizes atrial substrate progression in AF patients.
  • A higher Uni/Bi ratio during the initial ablation predicts greater expansion of bipolar LVZ during subsequent procedures.