{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T14:02:05Z","timestamp":1762956125883,"version":"3.37.3"},"reference-count":20,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2019,5,27]],"date-time":"2019-05-27T00:00:00Z","timestamp":1558915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Ultrahigh\u2010density\u2010voltage\u00a0mapping (uHD<jats:sub>V<\/jats:sub>M) is a new tool that can add new insights into the pathophysiology of atrial fibrillation (AF). The aim of this study was to evaluate the performance of uHD<jats:sub>V<\/jats:sub>M in predicting postablation AF recurrence (AFR).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>We included 98 consecutive patients undergoing pulmonary vein isolation for AF (40.8% persistent) using an uHD<jats:sub>V<\/jats:sub>M system and followed for 1 year. The left atrium (LA) mean voltage (<jats:italic>V<\/jats:italic><jats:sub>m<\/jats:sub>) and the <jats:italic>V<\/jats:italic><jats:sub>slope<\/jats:sub> (slope of the voltage histogram calculated by linear interpolation, with the relative frequency on the vertical axis and the bipolar potential on the horizontal axis) were calculated from 12\u2009567\u2009\u00b1\u20095486 points per map.<\/jats:p><jats:p>Patients with AFR (N\u2009=\u200929) had lower <jats:italic>V<\/jats:italic><jats:sub>m<\/jats:sub> and higher <jats:italic>V<\/jats:italic><jats:sub>slope<\/jats:sub> as compared with patients without AFR (N\u2009=\u200969). Receiver operating characteristic curves identified <jats:italic>V<\/jats:italic><jats:sub>m<\/jats:sub> as the strongest predictor of AFR, with a higher incidence of AFR in patients with <jats:italic>V<\/jats:italic><jats:sub>m<\/jats:sub> 0.758\u2009mV (57.6%) or lower than patients with <jats:italic>V<\/jats:italic><jats:sub>m<\/jats:sub> higher than 0.758\u2009mV (15.4%; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.0001). Among patients with <jats:italic>V<\/jats:italic><jats:sub>m<\/jats:sub>\u00a0higher than 0.758\u2009mV, patients with <jats:italic>V<\/jats:italic><jats:sub>slope<\/jats:sub> 0.637 or higher exhibited higher (<jats:italic>P<\/jats:italic>\u2009=\u2009.043) AFR incidence (31.3%) than patients with <jats:italic>V<\/jats:italic><jats:sub>slope<\/jats:sub> lower than 0.637 (10.2%). This classification showed incremental predictive value over relevant covariables. <jats:italic>V<\/jats:italic><jats:sub>m<\/jats:sub> values were lower and <jats:italic>V<\/jats:italic><jats:sub>slope<\/jats:sub> values were higher in patients that progressed from paroxysmal to persistent AF. Patients with V<jats:sub>slope<\/jats:sub> 0.637 or higher had a 14.2% incidence of postablation atypical atrial flutter, whereas patients with <jats:italic>V<\/jats:italic><jats:sub>slope<\/jats:sub> lower than 0.637 did not present this outcome.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The risk of AFR, atrial flutter, and progression from paroxysmal to persistent AF can be detected by quantitative analysis of LA uHD<jats:sub>V<\/jats:sub>M identifying diverse patterns of atrial substrate alterations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.13972","type":"journal-article","created":{"date-parts":[[2019,5,11]],"date-time":"2019-05-11T13:53:15Z","timestamp":1557582795000},"page":"1231-1240","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Association of left atrium voltage amplitude and distribution with the risk of atrial fibrillation recurrence and evolution after pulmonary vein isolation: An ultrahigh\u2010density mapping study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0346-2476","authenticated-orcid":false,"given":"Gabriel","family":"Ballesteros","sequence":"first","affiliation":[{"name":"Department of Cardiology and Cardiac Surgery Cl\u00ednica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susana","family":"Ravassa","sequence":"additional","affiliation":[{"name":"Program of Cardiovascular Diseases, Center for Applied Medical Research (CIMA) Universidad de Navarra  Pamplona Spain"},{"name":"IdiSNA Navarra Institute for Health Research  Pamplona Spain"},{"name":"CIBERCV Carlos III Institute of Health  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean","family":"Bragard","sequence":"additional","affiliation":[{"name":"Department of Physics and Applied Math Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pablo","family":"Ramos","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiac Surgery Cl\u00ednica Universidad de Navarra  Pamplona Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bego\u00f1a","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Program of Cardiovascular Diseases, Center for Applied Medical Research (CIMA) Universidad de Navarra  Pamplona Spain"},{"name":"IdiSNA Navarra Institute for Health Research  Pamplona Spain"},{"name":"CIBERCV Carlos III Institute of Health  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Enrique","family":"Vives","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiac Surgery Cl\u00ednica Universidad de Navarra  Pamplona 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U.","family":"Moreno","sequence":"additional","affiliation":[{"name":"Program of Cardiovascular Diseases, Center for Applied Medical Research (CIMA) Universidad de Navarra  Pamplona Spain"},{"name":"IdiSNA Navarra Institute for Health Research  Pamplona Spain"},{"name":"CIBERCV Carlos III Institute of Health  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"D\u00edez","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiac Surgery Cl\u00ednica Universidad de Navarra  Pamplona Spain"},{"name":"Program of Cardiovascular Diseases, Center for Applied Medical Research (CIMA) Universidad de Navarra  Pamplona Spain"},{"name":"IdiSNA Navarra Institute for Health Research  Pamplona Spain"},{"name":"CIBERCV Carlos III Institute of Health  Madrid Spain"},{"name":"Department of Nephrology Cl\u00ednica Universidad de Navarra  Pamplona 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