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Effect of bipolar electrode orientation on local electrogram properties.

Masateru Takigawa1, Jatin Relan2, Ruairidh Martin3

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Summary
This summary is machine-generated.

Electrograms (EGMs) show significant voltage variation based on bipolar orientation. Diagonally orthogonal electrode pairs can miss local ventricular abnormal activities (LAVAs), impacting diagnostic accuracy.

Keywords:
ElectrogramsInfarctionLAVAMappingMultipolar cathetersVoltage

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Area of Science:

  • Electrophysiology
  • Cardiovascular Research
  • Medical Device Technology

Background:

  • The impact of bipolar orientation on electrograms (EGMs) is not well understood.
  • Accurate interpretation of EGMs is crucial for diagnosing cardiac conditions.

Purpose of the Study:

  • To investigate how diagonally orthogonal bipolar electrode pairs influence local electrogram measurements.
  • To assess the variability in EGMs introduced by different bipolar orientations.

Main Methods:

  • Utilized the HD-32 Grid catheter in seven sheep with induced anterior myocardial infarction.
  • Compared local EGMs from diagonally orthogonal electrode pairs (e.g., southeast vs. northeast directions).
  • Analyzed 4084 EGMs across infarcted, border, and normal myocardial regions.

Main Results:

  • Significant differences in measured voltages were observed between opposing orthogonal bipolar pairs (P < .0001).
  • Voltage variation reached up to 48.7% when the activation wavefront was perpendicular to one bipolar direction.
  • Local ventricular abnormal activities (LAVAs) were missed in 29.9% to 30.4% of sites, and only 56.6% of LAVAs matched between orthogonal pairs.

Conclusions:

  • Bipolar electrogram voltage and LAVA detection are significantly influenced by the orientation of diagonally orthogonal electrode pairs.
  • This orientation-dependent variability can affect the detection and characterization of abnormal cardiac electrical activity.