BACKGROUND Abnormal atrial potentials (AAPs) recorded during sinus rhythm/atrial pacing may indicate areas of slow conduction capable of supporting reentrant atrial tachycardia (AT). Therefore, we sought to examine the relationship between AAPs and AT circuits. METHODS One hundred twenty-three reentrant ATs in 104 patients were analyzed. AAPs, consisting of fragmented potentials and split potentials, were assessed using the Rhythmia LUMIPOINT algorithm. RESULTS There was 93±13% overlap between areas with AAPs during sinus rhythm/atrial pacing and areas of slow conduction along the reentry circuit during AT. The cumulative area of AAPs was smaller in patients with localized-reentrant ATs compared with anatomic macro-reentrant ATs (20.0 [14.6-30.5] versus 28.9 [21.8-35.6] cm2; P=0.021). Patients with perimitral ATs had larger areas of AAPs on the lateral wall whereas patients with roof-dependent ATs had larger areas of AAPs on the roof and posterior wall (P≤0.018 for all comparisons). The patchy scar that was associated with localized-reentrant AT exhibited a larger area of AAPs at its periphery than the scar that did not participate in localized-reentrant AT (3.1 [2.4-4.5] versus 1.0 [0.7-1.6] cm2; P<0.001). CONCLUSIONS AAPs recorded during sinus rhythm/atrial pacing are associated with areas of slow conduction during reentrant AT. The burden and distribution of AAPs may provide actionable insights into AT circuit features, including in cases in which ATs are difficult to map.

中文翻译：

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窦性心律或起搏期间记录的异常心房电位代表折返性房性心动过速的基础。

背景技术在窦性心律/心房起搏期间记录的异常心房电位（AAP）可能表明能够支持折返性房性心动过速（AT）的慢传导区域。因此，我们试图研究 AAP 和 AT 电路之间的关系。方法 对 104 名患者的 123 个折返性 AT 进行了分析。使用 Rhythmia LUMIPOINT 算法评估由碎片电位和分裂电位组成的 AAP。结果 窦性心律/心房起搏期间的 AAP 区域与 AT 期间沿折返回路的慢传导区域之间存在 93±13% 的重叠。与解剖学大折返 AT 患者相比，局部折返 AT 患者的 AAP 累积面积较小（20.0 [14.6-30.5] vs 28.9 [21.8-35.6] cm2；P=0.021）。患有周围 AT 的患者在侧壁上有较大的 AAP 面积，而患有屋顶依赖性 AT 的患者在屋顶和后壁上有较大的 AAP 面积（所有比较 P≤0.018）。与局部折返性 AT 相关的斑片状疤痕在其周围表现出比不参与局部折返性 AT 的疤痕更大的 AAP 面积（3.1 [2.4-4.5] vs 1.0 [0.7-1.6] cm2；P< 0.001）。结论 窦性心律/心房起搏期间记录的 AAP 与折返 AT 期间的慢传导区域相关。AAP 的负担和分布可以为 AT 电路特征提供可操作的见解，包括在 AT 难以映射的情况下。