Performance assessment of electrode configurations for the estimation of omnipolar electrograms from high density arrays

Castells, Francisco; Ruipérez-Campillo, Samuel; Segarra, Izan; Cervigón, Raquel; Casado-Arroyo, Rubén; Merino, José Luís; Millet, José

doi:10.1016/j.compbiomed.2023.106604

Cited by 8 publications

(9 citation statements)

References 26 publications

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“…As suggested from previous simulations [ 25 ], the reliability of oEGM estimations depends on several factors. Some of them are inherent to physiological properties, such as conduction velocity and the morphology of the unipolar signal.…”

Section: Methodsmentioning

confidence: 98%

“…From its orthogonal components, the electric field generated by the cardiac electrical activation can be represented as a loop pointing in the direction of propagation. Under the conditions of planar and homogeneous wavefronts (more likely to apply in small-size cliques), it can be stated that the narrower the loop, the more precise the description of the electric field [ 24 , 25 ].…”

Section: Methodsmentioning

confidence: 99%

“…Although omnipolar electrodes are claimed to provide an orientation-independent oEGM [ 11 , 22 , 23 ], some orientation dependencies have been reported [ 24 , 25 ], which may lead to pitfalls in oEGM estimation at some incidence angles. To overcome this limitation, two alternative methods for oEGM estimation have been recently proposed.…”

Section: Introductionmentioning

confidence: 99%

“…The second one refers to a cross-orientation method by choosing the diagonal bEGMs of the square clique, as opposed to the conventional triangular configuration. This method is proposed as a way to impose coincident bipole centres [ 25 ], and hence avoid delays between bEGMs. Although the latter method showed promising results towards overcoming the aforementioned limitations and presenting a more robust approach against propagation angle, this was only tested with simulations based on ideal propagation wavefronts presented as homogeneous and plane waves, which differ from the non-ideal propagation patterns intrinsic to the electrophysiological environment [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation and assessment of clique arrangements for the estimation of omnipolar electrograms in high density electrode arrays: an experimental animal model study

et al. 2023

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High-density catheters combined with Orientation Independent Sensing (OIS) methods have emerged as a groundbreaking technology for cardiac substrate characterisation. In this study, we aim to assess the arrangements and constraints to reliably estimate the so-called omnipolar electrogram (oEGM). Performance was evaluated using an experimental animal model. Thirty-eight recordings from nine retrospective experiments on isolated perfused rabbit hearts with an epicardial HD multielectrode were used. We estimated oEGMs according to the classic triangular clique (4 possible orientations) and a novel cross-orientation clique arrangement. Furthermore, we tested the effects of interelectrode spacing from 1 to 4 mm. Performance was evaluated by means of several parameters that measured amplitude rejection ratios, electric field loop area, activation pulse width and morphology distortion. Most reliable oEGM estimations were obtained with cross-configurations and interelectrode spacings $$\le 2$$ ≤ 2 mm. Estimations from triangular cliques resulted in wider electric field loops and unreliable detection of the direction of the propagation wavefront. Moreover, increasing interelectrode distance resulted in increased pulse width and morphology distortion. The results prove that current oEGM estimation techniques are insufficiently accurate. This study opens a new standpoint for the design of new-generation HD catheters and mapping software.

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Section: Methodsmentioning

confidence: 98%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation and assessment of clique arrangements for the estimation of omnipolar electrograms in high density electrode arrays: an experimental animal model study

et al. 2023

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“…The cross-clique configuration for the omnipolar reconstruction of signals was implemented, as described in [30] and validated in an animal experimental model in [31] . From a \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} $4\times 4$\end{document} electrode grid and according to the definition of a clique, a \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} $3\times 3$\end{document} vector map is generated that displays the propagation of the wave under the catheter.…”

Section: Methodsmentioning

confidence: 99%

Vector Field Heterogeneity for the Assessment of Locally Disorganised Cardiac Electrical Propagation Wavefronts From High-Density Multielectrodes

Pancorbo,

Ruipérez-Campillo,

Tormos

et al. 2024

IEEE Open J. Eng. Med. Biol.

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High-density multielectrode catheters are becoming increasingly popular in cardiac electrophysiology for advanced characterisation of the cardiac tissue, due to their potential to identify impaired sites. These are often characterised by abnormal electrical conduction, which may cause locally disorganised propagation wavefronts. To quantify it, a novel heterogeneity parameter based on vector field analysis is proposed, utilising finite differences to measure direction changes between adjacent cliques. The proposed Vector Field Heterogeneity metric has been evaluated on a set of simulations with controlled levels of organisation in vector maps, and a variety of grid sizes. Furthermore, it has been tested on animal experimental models of isolated Langendorff-perfused rabbit hearts. The proposed parameter exhibited superior capturing ability of heterogeneous propagation wavefronts compared to the classical Spatial Inhomogeneity Index, and simulations proved that the metric effectively captures gradual increments in disorganisation in propagation patterns. Notably, it yielded robust and consistent outcomes for \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{upgreek} \usepackage{mathrsfs} \setlength{\oddsidemargin}{-69pt} \begin{document} $\mathbf {4\times 4}$\end{document} grid sizes, underscoring its suitability for the latest generation of orientation-independent cardiac catheters.

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Advanced Electroanatomic Mapping: Current and Emerging Approaches

Narayan,

John

2024

Curr Treat Options Cardio Med

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Purpose of review Contemporary ablation for complex arrhythmias raises several challenges for electroanatomic mapping. We examine how current and emerging systems may meet these challenges, and we outline major unmet needs. Recent findings The latest versions of the 3 major systems (Carto™, Ensite X™, and Rhythmia™) all construct near real-time maps of cardiac anatomy, which can be registered to tomographic images that integrate thousands of electrical points from high-resolution catheters to create activation maps, and display voltage, proprietary features, and ablation lesion locations. While these systems have improved procedural efficiency, it is less clear that they have improved ablation outcomes particularly for atrial fibrillation (AF), scar-related atrial flutter, ventricular tachycardia (VT), and fibrillation (VF). These remain urgent needs. Summary Cardiac electroanatomic mapping has reached a mature stage for supraventricular and many ventricular arrhythmias. Novel functional mapping systems have shown success in improving ablation outcomes for AF, VT, and VF in small patient series, but none in randomized trials of broad unselected patient cohorts.

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Performance assessment of electrode configurations for the estimation of omnipolar electrograms from high density arrays

Cited by 8 publications

References 26 publications

Evaluation and assessment of clique arrangements for the estimation of omnipolar electrograms in high density electrode arrays: an experimental animal model study

Evaluation and assessment of clique arrangements for the estimation of omnipolar electrograms in high density electrode arrays: an experimental animal model study

Vector Field Heterogeneity for the Assessment of Locally Disorganised Cardiac Electrical Propagation Wavefronts From High-Density Multielectrodes

Advanced Electroanatomic Mapping: Current and Emerging Approaches

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