Evaluating the atrial substrate

Adverse atrial remodeling is multi-faceted and likely to be driven by disease processes that increase AF risk. Consequently, remodeling phenomena are unlikely to follow a stereotyped process and the nature of the arrhythmogenic substrate will vary depending on the circumstances and clinical profile of the patient. Despite these challenges, the alterations in electrophysiological properties have been proposed to manifest as a reduction in bipolar voltage and thus be an effective means of discriminating arrhythmogenic tissue from healthy areas within the left atrium, and particularly a marker for atrial fibrosis.