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Related Experiment Videos

Epicardial mapping: how to measure local activation?

T Paul1, J P Moak, C Morris

  • 1Department of Pediatric Cardiology, Children's Hospital, Medizinische Hochschule Hannover, Federal Republic of Germany.

Pacing and Clinical Electrophysiology : PACE
|March 11, 1990
PubMed
Summary

Maximal amplitude of bipolar electrograms closely matches unipolar electrogram analysis for epicardial mapping. However, using bipolar electrogram onset may lead to inaccurate timing and location of ventricular activation.

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Area of Science:

  • Cardiovascular Electrophysiology
  • Cardiac Mapping Technology

Background:

  • Epicardial ventricular mapping is crucial for understanding cardiac arrhythmias.
  • Accurate determination of local epicardial activation is essential for effective mapping.
  • Different electrogram analysis methods may yield varying results.

Purpose of the Study:

  • To compare four definitions of local epicardial activation during sinus rhythm.
  • To evaluate the accuracy and consistency of different mapping criteria.
  • To identify potential misinterpretations in cardiac activation timing and location.

Main Methods:

  • Epicardial mapping in 5 dogs using a 41-electrode sock array.
  • Computer-assisted mapping system employed.
  • Analysis of unipolar and bipolar electrograms using four distinct activation criteria: maximal negative slope (unipolar), maximal slope (bipolar), maximal amplitude (bipolar), and 45-degree onset (bipolar).

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Main Results:

  • Identical sites for earliest and latest epicardial activation were found using maximal negative slope (unipolar) and maximal slope/amplitude (bipolar) across all animals.
  • Activation times calculated with maximal bipolar electrogram amplitude closely resembled those from maximal negative unipolar slope.
  • Bipolar electrogram onset resulted in activation times 10-12 msec earlier and, in two cases, identified a different epicardial breakthrough site.

Conclusions:

  • Maximal bipolar electrogram amplitude correlates well with maximal negative unipolar electrogram slope for epicardial mapping.
  • The onset criterion for bipolar electrograms can potentially misrepresent the timing and location of earliest epicardial activation.