J Clin Monit Comput - Improved spatial resolution and electrogram wave direction independence with the use of an orthogonal electrode configuration.

Tópicos

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Resumo

To improve spatial resolution in recordings of intra-cardiac electrograms we characterized the utility of a novel configuration of two recording electrodes arranged perpendicularly to the endocardial surface. We hypothesized that this configuration denoted as orthogonal close unipolar (OCU) would combine advantages of conventional unipolar and contact bipolar (CBP) configurations. Electrical excitation was simulated in a computational model as arising from dipole current or from multi-wavelet reentry sources. Recordings were calculated for electrode tips 1 mm above the plane of the heart. Analogous recordings were obtained from swine hearts. Electrograms recorded with CBP showed strong dependence on orientation of the electrode pair with respect to the direction of spread of tissue excitation. By contrast, OCU recordings exhibited no directional dependence. OCU was significantly superior to CBP with respect to avoidance of far-field confounding of local tissue activity; the average far-field/near-field ratios for CBP and OCU were 0.09 and 0.05, respectively, for the simulated dipole current sources. In the swine hearts the ratios of ventricular to atrial signals for CBP and OCU were 0.15 ? 0.07 and 0.08 ? 0.09, respectively (p < 0.001). The difference between the actual dominant frequency in the tissue and that recorded by the electrodes was 0.44 ? 0.33 Hz for OCU, 0.58 ? 0.40 Hz for unipolar, and 0.62 ? 0.46 Hz for CBP. OCU confers improved spatial resolution compared with both unipolar and CBP electrode configurations. Unlike the case with CBP, OCU recordings are independent of excitation wave-front direction.

Resumo Limpo

improv spatial resolut record intracardiac electrogram character util novel configur two record electrod arrang perpendicular endocardi surfac hypothes configur denot orthogon close unipolar ocu combin advantag convent unipolar contact bipolar cbp configur electr excit simul comput model aris dipol current multiwavelet reentri sourc record calcul electrod tip mm plane heart analog record obtain swine heart electrogram record cbp show strong depend orient electrod pair respect direct spread tissu excit contrast ocu record exhibit direct depend ocu signific superior cbp respect avoid farfield confound local tissu activ averag farfieldnearfield ratio cbp ocu respect simul dipol current sourc swine heart ratio ventricular atrial signal cbp ocu respect p differ actual domin frequenc tissu record electrod hz ocu hz unipolar hz cbp ocu confer improv spatial resolut compar unipolar cbp electrod configur unlik case cbp ocu record independ excit wavefront direct

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