Effect of electrode size and spacing on electrograms: Optimized electrode configuration for near-field electrogram characterization

Takigawa, Masateru; Kitamura, Τakeshi; Basu, Shubhayu; Bar-Tal, Meir; Martin, Claire; Martin, Ruairidh; Cheniti, Ghassen; Vlachos, Konstantinos; Pillois, Xavier; Frontera, Antonio; Massoullié, Grégoire; Thompson, Nathaniel; Bourier, Félix; Lam, Anna; Duchâteau, Josselin; Pambrun, Thomas; Denis, Arnaud; Derval, Nicolas; Cochet, Hubert; Haı̈ssaguerre, Michel; Sacher, Frédéric; Hocini, Mélèze; Jaı̈s, Pierre

doi:10.1016/j.hrthm.2021.09.011

Cited by 20 publications

(22 citation statements)

References 13 publications

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“…Peak-to-peak voltage is used as a marker to distinguish healthy from pathological tissue both for biEGMs ( Jadidi et al, 2020 ) and uEGMs ( Nairn et al, 2020b ). However, biEGM amplitude can be affected by to several factors ( Hwang et al, 2019 ) such as the orientation of the catheter ( Schuler et al, 2013 ; Gaeta et al, 2020 ), the electrode spacing and size ( Beheshti et al, 2018 ; Abdi et al, 2020 ; Nairn et al, 2020a ; Takigawa et al, 2022 ), depolarization patterns ( Jacquemet et al, 2003 ), substrate remodeling ( Jacquemet et al, 2003 ; McDowell et al, 2012 ; Campos et al, 2013 ; Mendonca Costa et al, 2014 ; Roney et al, 2016 ; Sánchez et al, 2021b ) and signal filter settings ( Starreveld et al, 2020 ).…”

Section: Intracardiac Electrogramsmentioning

confidence: 99%

A Review of Healthy and Fibrotic Myocardium Microstructure Modeling and Corresponding Intracardiac Electrograms

Loewe

2022

Front. Physiol.

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Computational simulations of cardiac electrophysiology provide detailed information on the depolarization phenomena at different spatial and temporal scales. With the development of new hardware and software, in silico experiments have gained more importance in cardiac electrophysiology research. For plane waves in healthy tissue, in vivo and in silico electrograms at the surface of the tissue demonstrate symmetric morphology and high peak-to-peak amplitude. Simulations provided insight into the factors that alter the morphology and amplitude of the electrograms. The situation is more complex in remodeled tissue with fibrotic infiltrations. Clinically, different changes including fractionation of the signal, extended duration and reduced amplitude have been described. In silico, numerous approaches have been proposed to represent the pathological changes on different spatial and functional scales. Different modeling approaches can reproduce distinct subsets of the clinically observed electrogram phenomena. This review provides an overview of how different modeling approaches to incorporate fibrotic and structural remodeling affect the electrogram and highlights open challenges to be addressed in future research.

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Section: Intracardiac Electrogramsmentioning

confidence: 99%

A Review of Healthy and Fibrotic Myocardium Microstructure Modeling and Corresponding Intracardiac Electrograms

Loewe

2022

Front. Physiol.

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“…Second, the catheter’s small electrode (0.9 mm 2 ) may improve OWM’s accuracy as it can reduce the recording of far-field potentials. 4 , 5 Third, this catheter has a reference electrode at the confluence of the splines (TRUEref technology; Biosense Webster, Inc). This reference electrode might increase the OWM’s quality by reducing the impact of the far-field potentials on unipolar signals.…”

Section: Discussionmentioning

confidence: 99%

Dual-chamber open-window mapping with a novel multispline mapping catheter for a left posterolateral atrioventricular accessory pathway

Nakatani

Take²,

Takizawa³

et al. 2023

HeartRhythm Case Reports

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“…Many aspects of the signal acquisition influence the morphology of the contact electrograms [10]. This in silico study focuses on characterising the influence on OE morphology of inter-electrode distance and the number of electrodes in the clique.…”

Section: Introductionmentioning

confidence: 99%

The effects of electrode configuration on omnipolar signals: An in-silico approach

Kumar¹,

Brook²,

Ntagiantas³

et al. 2022

Computing in Cardiology Conference (CinC)

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Atrial Fibrillation (AF) is the most common cardiac arrhythmia, involving pathological triggers and substrate in the atria. In the clinical catheter laboratory, contact electrograms are an essential tool to characterise AF. Omnipolar electrograms (OE), derived from three or more neighbouring electrodes, are thought to be superior compared to traditional unipolar and bipolar electrograms by eliminating far-field effects and correcting for wavefront incidence angle. We sought to understand the changes in OE morphology under different electrode configurations using 2D simulations of healthy tissue and scarred tissue. Virtual unipolar electrograms (UE) were generated from single electrodes which were used to predict the local electric field and subsequently calculate OEs in cliques of 3, 4, and 6 electrodes at different inter-electrode spacings. Five features were identified on each OE to measure changes in OE morphology under different clique configurations. Additionally, the morphology of the OE signals in the presence of fibrosis was examined. OE signals obtained from scarred tissue are more fractionated compared to healthy tissue. The most appropriate inter-electrode distance for interpreting the OE signals was found to be 2-3mm, using either three or four electrodes.

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Effect of electrode size and spacing on electrograms: Optimized electrode configuration for near-field electrogram characterization

Cited by 20 publications

References 13 publications

A Review of Healthy and Fibrotic Myocardium Microstructure Modeling and Corresponding Intracardiac Electrograms

A Review of Healthy and Fibrotic Myocardium Microstructure Modeling and Corresponding Intracardiac Electrograms

Dual-chamber open-window mapping with a novel multispline mapping catheter for a left posterolateral atrioventricular accessory pathway

The effects of electrode configuration on omnipolar signals: An in-silico approach

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