Investigating the high correlation between unipolar and bipolar voltage maps
Atrial fibrillation (AF) is a common cardiac arrhythmia characterised by an irregular heart rhythm, which can cause various complications such as heart failure and stroke. Catheter ablation of the pulmonary veins is an effective therapy for patients suffering from paroxysmal atrial fibrillation (AF). However, medicine is lacking a reliable curative therapy for patients with persistent AF. Recently, catheter ablation targeting areas of low voltage identified by bipolar intracardiac mapping has gained attention as a promising approach for persistent AF patients. Besides local myocardial fibrosis causing reduced amplitude, bipolar voltage amplitudes may be influenced by inter-electrode spacing and bipole-to-wavefront-angle. It is unclear to what extent these impact low voltage areas (LVA) in the clinical setting. Alternatively, unipolar electrogram voltage is not affected by these factors but requires advanced filtering. We recently looked at the correlation between bipolar and unipolar mapping in terms of classifying areas of low voltage and identified a strong correlation between the two modalities. However, it is important to further investigate and understand the reasons behind the high correlation. This work will therefore consist of gaining a deeper insight into the relationship of bipolar and unipolar voltage maps.