Resolving Bipolar Electrogram Voltages During Atrial Fibrillation Using Omnipolar Mapping
Resolving Bipolar Electrogram Voltages During Atrial Fibrillation Using Omnipolar Mapping
复制标题
DOI：
10.1161/circep.117.005018
复制
发表时间：
2017-09-01
影响因子：
8.4
通讯作者：
Nanthakumar, Kumaraswamy
中科院分区：
文献类型：
--
作者：
Haldar, Shouvik K.;Magtibay, Karl;Nanthakumar, Kumaraswamy
背景：低电压引导的基质修饰是房颤（AF）消融的一种新兴策略。AF中当代双极电描记图（EGM）分析的主要限制是相对于电极方向的波前方向变化以及分馏和碰撞事件导致的较低峰间电压（V-pp）。我们的目的是比较双极V-PP与新的全极峰-峰电压（V-最大值）在窦性心律（SR）和AF。方法和结果：高密度固定的多电极斑块被放置在犬左心房的心外膜表面。在SR和AF中获得水平和垂直方向双极EGM，然后是全极EGM，并进行比较。双极方向对SR和AF期间获得的双极EGM电压有显著影响。在SR中，垂直值平均比水平值大66 +/- 119%（P=0.004）。在AF中，垂直值平均比水平值大31 +/- 96%（P=0.07）。全极V-max值比水平方向大99.9 +/- 125%（99.9 +/- 125%; P
BACKGROUND: Low-voltage-guided substrate modification is an emerging strategy in atrial fibrillation (AF) ablation. A major limitation to contemporary bipolar electrogram (EGM) analysis in AF is the resultant lower peak-to-peak voltage (V-pp) from variations in wavefront direction relative to electrode orientation and from fractionation and collision events. We aim to compare bipole V-pp with novel omnipolar peak-to-peak voltages (V-max) in sinus rhythm (SR) and AF.METHODS AND RESULTS: A high-density fixed multielectrode plaque was placed on the epicardial surface of the left atrium in dogs. Horizontal and vertical orientation bipolar EGMs, followed by omnipolar EGMs, were obtained and compared in both SR and AF. Bipole orientation has significant impact on bipolar EGM voltages obtained during SR and AF. In SR, vertical values were on average 66 +/- 119% larger than horizontal (P=0.004). In AF, vertical values were on average 31 +/- 96% larger than horizontal (P=0.07). Omnipole V-max values were 99.9 +/- 125% larger than both horizontal (99.9 +/- 125%; P