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Reinserting Physiology into Cardiac Mapping Using Omnipolar Electrograms.

Karl Magtibay1, Andreu Porta-Sánchez2, Shouvik K Haldar3

  • 1The Hull Family Cardiac Fibrillation Management Laboratory, Toronto General Hospital, University Health Network, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada.

Cardiac Electrophysiology Clinics
|August 12, 2019
PubMed
Summary
This summary is machine-generated.

Omnipolar electrograms (EGMs) offer catheter-orientation-independent cardiac electrophysiology assessments. This technology uses biophysical electric fields to map myocardial activation, aiding in identifying scar, gaps, and arrhythmias.

Keywords:
Activation directionAtrial fibrillationCardiac mappingConduction velocityElectrogram directionOmnipolarVentricular tachycardiaWavefront orientation

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Area of Science:

  • Cardiac electrophysiology
  • Biophysics
  • Medical instrumentation

Background:

  • Traditional electrograms (EGMs) provide limited directional information.
  • Cardiac activation mapping is crucial for understanding heart function and disease.
  • Catheter orientation can affect the accuracy of traditional EGM measurements.

Purpose of the Study:

  • To introduce and validate omnipolar electrograms (EGMs) for comprehensive cardiac electrophysiology assessment.
  • To demonstrate the utility of omnipolar EGMs in characterizing myocardial properties.
  • To improve the localization of cardiac abnormalities like scar and arrhythmia substrates.

Main Methods:

  • Utilized a grid-like electrode array to capture bipolar signals in orthogonal directions.
  • Validated omnipolar EGM principles using myocyte monolayers, isolated animal and human hearts, and anesthetized animal models.
  • Combined omnipolar-based activation vectors and voltages for analysis.

Main Results:

  • Omnipolar EGMs provide catheter-orientation-independent assessments of cardiac electrophysiology.
  • Demonstrated the ability to characterize myocardial activation using biophysical electric fields.
  • Showcased potential for localizing scar, lesion gaps, and wavefront disorganization during arrhythmias.

Conclusions:

  • Omnipolar EGMs represent a significant advancement in cardiac electrophysiology.
  • This technology enhances the characterization of myocardium by incorporating directional electrogram information.
  • Omnipolar EGMs show promise for improved diagnosis and treatment guidance in cardiac arrhythmias and structural heart disease.