{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T01:29:01Z","timestamp":1785029341125,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,6,3]],"date-time":"2023-06-03T00:00:00Z","timestamp":1685750400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2023,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Atrial tachycardia (AT)\u00a0is a commonly encountered rhythm disorder in patients with underlying atrial scar. The role of atrial late activation mapping during sinus rhythm to predict the critical isthmus (CI) of AT has yet to be systematically evaluated. We aimed to investigate the relationship between the functional substrate mapping (FSM)\u00a0characteristics and the CI of reentrant ATs in patients with underlying atrial low\u2010voltage areas.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients with history of left AT who underwent catheter ablation with 3D mapping using high\u2010density mapping were enrolled. Voltage map and isochronal late activation mapping were created during sinus\/paced rhythm to detect deceleration zones (DZ).\u00a0Electrograms with continuous\u2010fragmented morphology were also tagged. After induction of AT, activation mapping was performed to detect CI of the tachycardia. Atrial tachyarrhythmia (ATa) recurrence was defined as detection of atrial fibrillation or AT (\u226530\u2009s) during the follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 35 patients [mean age: 62\u2009\u00b1\u20099, gender: 25 (71.5%) female] with left AT, a total of 42 reentrant ATs induced. Voltage mapping during sinus rhythm revealed low\u2010voltage area of 37.1\u2009\u00b1\u200923.8% of the left atrium. The mean value of bipolar voltage, EGM duration, and conduction velocity during sinus rhythm corresponding to CI of ATs were 0.18\u2009\u00b1\u20090.12\u2009mV, 133\u2009\u00b1\u200947\u2009ms, and 0.12\u2009\u00b1\u20090.09\u2009m\/s, respectively. Total number of DZs per chamber was 1.5\u2009\u00b1\u20090.6, which were located in the low\u2010voltage zone (&lt;0.5\u2009mV) detected by high\u2010density mapping. All CIs of reentry were colocalized with DZs detected during FSM. The positive predictive value of DZs to detect CI of inducible ATs is 80.4%. Freedom from ATa after the index procedure was 74.3% during a mean follow\u2010up of 12.2\u2009\u00b1\u20097.5 months.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our findings demonstrated the utility of FSM during sinus rhythm to predict the CI of AT. DZs displayed continuous\u2010fragmented signal morphology with slow conduction which may guide to tailor ablation strategy in case of underlying atrial scar.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jce.15961","type":"journal-article","created":{"date-parts":[[2023,6,3]],"date-time":"2023-06-03T10:49:05Z","timestamp":1685789345000},"page":"1539-1548","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Functional substrate mapping characteristics during sinus rhythm predicts critical isthmus of reentrant atrial tachycardia"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7673-229X","authenticated-orcid":false,"given":"Hikmet","family":"Yorgun","sequence":"first","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine Hacettepe University Ankara Turkey"},{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cem","family":"\u00c7\u00f6teli","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine Hacettepe University Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcl Sinem","family":"K\u0131l\u0131\u00e7","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine Hacettepe University Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6386-7045","authenticated-orcid":false,"given":"Burak","family":"Sezen\u00f6z","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine Hacettepe University Ankara Turkey"},{"name":"Department of Cardiology, Faculty of Medicine Gazi University  Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7227-8114","authenticated-orcid":false,"given":"Muhammet","family":"Dural","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardiovascular Research Institute Maastricht (CARIM) Maastricht University Medical Center Maastricht The Netherlands"},{"name":"Department of Cardiology, Faculty of Medicine Osmangazi University Eski\u015fehir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmet Hakan","family":"Ate\u015f","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine Hacettepe University Ankara Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kudret","family":"Aytemir","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Faculty of Medicine Hacettepe University Ankara 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