Mapping of the Atrial Electrogram in Sinus Rhythm and Different Atrial Fibrillation Substrates

Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice. In recent years, growing knowledge of atrial substrate mapping has helped us to characterize atrial substrate. In clinical mapping, individual knowledge of sinus rhythm activity may help in identification of mechanism and the critical targets for AF. In this review chapter, we firstly focus on three-dimensional (3D) mapping techniques in time-domain electrogram and frequency-domain spectra from intracardiac recording. Secondly, we focus on substrate mapping has helped to depict the sequence of the activation time, electrogram voltage and electrogram characteristic during sinus rhythm (SR), in detecting substrate abnormality, potential sinus node dysfunction and slow-conduction area or scar. Lastly, we focus on spectral analysis is to elucidate the data beyond the time-domain electrogram. Spectral analysis during SR also provides information regarding abnormal arrhythmogenic substrate and may indicate the parasympathetic innervation sites. These may be helpful for the understanding of AF. This edition first published 2013