Omnipolar Technology in Intracardiac signals: Are We Fulfilling the Assumptions?

The HD-Grid catheter is widely in clinical practice for intracavitary electrical mapping. However, its interelectrode spacing does not always ensure compliance with the assumptions of waveform homogeneity, amplitude consistency, and planar wavefront propagation required by the traveling wave theory underlying omnipolar reconstruction. In this study we aim to quantify the extend to which these assumptions hold by introducing the Amplitude Variability, Morphology, and Non-Planarity parameters. Additionally, we propose a solution to this limitation through unipolar signal interpolation to increase virtual spatial resolution and ensure accurate omnipolar signal reconstruction and biomarkers extraction. Out method employs a linear combination of unipolar HD-Grid signals, weighted using spline interpolation the inverse of the distance. Results indicate that compliance with the theoretical assumptions is influenced by interelectrode distance, with optimal adherence achieved at electrode spacings of 0.5 mm, ensuring remains within a 5% tolerance across all parameters. The proposed method improves adherence to the theoretical assumptions, enabling more reliable omnipolar signal reconstruction, thereby enhancing the characterization of intracardiac propagation patterns towards a more accurate localization of ablation targets.Clinical Relevance- Non-adherence to the theoretical assumptions in omnipolar technology can lead to inaccurate characterization of cardiac propagation patterns. The proposed method enhances compliance with these assumptions, yielding a more accurate representation of the omnipolar signal.