Single Catheter Determination of Local Electrogram Prematurity Using Simultaneous Unipolar and Bipolar Recordings to Replace the Surface ECG as a Timing Reference
| Autor: | Etienne Delacrétaz, Venkateshwar Gottipaty, Corinna B. Brunckhorst, Peter L. Friedman, William G. Stevenson, Kyoko Soejima |
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| Rok vydání: | 2001 |
| Předmět: |
Tachycardia
Ectopic Atrial Tachycardia medicine.medical_specialty Heart Ventricles medicine.medical_treatment Catheter ablation Ventricular tachycardia Sensitivity and Specificity Signal Electrocardiography Surface ecg QRS complex Internal medicine mental disorders medicine Humans Heart Atria Electrodes Atrial tachycardia business.industry Signal Processing Computer-Assisted Equipment Design General Medicine medicine.disease Ventricular Premature Complexes Catheter Catheter Ablation Tachycardia Ventricular cardiovascular system Cardiology medicine.symptom Cardiology and Cardiovascular Medicine business |
| Zdroj: | Pacing and Clinical Electrophysiology. 24:441-449 |
| ISSN: | 1540-8159 0147-8389 |
| DOI: | 10.1046/j.1460-9592.2001.00441.x |
| Popis: | Bipolar recordings eliminate much of the far-field signal, while minimally filtered unipolar recordings contain substantial far-field signal components. These properties may allow the onset of the unipolar recording to serve as a timing reference for the bipolar recording obtained from the same electrode catheter during mapping of focal atrial or ventricular tachycardias. Mapping and RF ablation were performed in 26 patients with focal ventricular tachycardia and 14 patients with focal atrial tachycardia. At 205 mapping sites, simultaneous recordings of (1) minimally filtered unipolar electrograms (0.5-500 Hz), (2) high pass filtered unipolar electrograms (100 Hz), and (3) filtered bipolar recordings (30-500 Hz) were analyzed. The interval between the onset of the minimally filtered unipolar electrogram and the first peak of the bipolar electrogram (UniOn-BiP) correlated closely with the timing of the local electrogram referenced to the surface ECG (r = 0.85, P < 0.001). Of 53 sites where RF ablation was performed, UniOn-BiP was shorter at successful compared to unsuccessful sites (3.8 +/- 3.5 vs 9.2 +/- 5.2 ms, P < 0.001) and was < 15 ms at all successful sites. In conclusion, the comparison of simultaneous unipolar and bipolar electrograms from a single catheter allows assessment of the prematurity of local electrograms from a focal source without the use of the P wave or QRS onset as a timing reference. |
| Databáze: | OpenAIRE |
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