Investigating the high correlation between unipolar and bipolar voltage maps

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Atrial fibrillation (AF) is a common cardiac arrhythmia characterised by an irregular heart rhythm. Pulmonary vein isolation is an effective therapy for patients suffering from paroxysmal AF. However, medicine is lacking a reliable curative therapy for patients with persistent AF. Recently, catheter ablation targeting low voltage areas (LVA) has gained attention as a promising approach. Besides arrhythmogenic substrate causing reduced amplitudes, bipolar amplitudes may be influenced by inter-electrode spacing and bipole-to-wavefront-angle. It is unclear to what extent these impact LVA in the clinical setting. We recently looked at the correlation between bipolar and unipolar mapping in terms of classifying LVA and identified a strong correlation between the two modalities. However, it is important to further investigate and understand the reasons behind the high correlation.