5.3. LACV and low-voltage area
Patients in the present study with low-voltage areas had a slower LACV
than those without. Previous studies reported that local conduction
velocity in low-voltage areas was significantly slower than that in
preserved-voltage areas.17Conduction
slowing and low voltage are therefore likely different manifestations of
the same pathophysiological phenomenon, such as
fibrosis.9, 10, 18 Of note, this study showed that a
slow anterior LACV was a better predictor of AF recurrence than the
existence of low-voltage areas. The bipolar voltage and extent of a
low-voltage area could be markedly influenced by any of several factors,
such as the mapping catheter used (electrode profile) and catheter
orientation in relation to propagation direction.19,
20 One advantage of LACV measurement is that it provides a
comprehensive assessment of all
mapping points, and is less dependent on individual electrogram signals.
As a result, LACV values measured in one electrophysiological laboratory
using a specific mapping catheter might be universally reproducible in
other laboratories using different mapping catheters.