Journal of Cardiovascular Translational Research ( IF 2.4 ) Pub Date : 2021-03-29 , DOI: 10.1007/s12265-021-10111-1 Lisette J M E van der Does 1 , Roeliene Starreveld 1 , Rohit K Kharbanda 1, 2 , Paul Knops 1 , Charles Kik 2 , Ad J J C Bogers 2 , Natasja M S de Groot 1
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Endo-epicardial asynchrony (EEA) is a new mechanism possibly maintaining atrial fibrillation. We aimed to determine the sensitivity and best recording modus to detect EEA on electrograms recorded from one atrial side using electrogram fractionation. Simultaneously obtained right atrial endo- and epicardial electrograms from 22 patients demonstrating EEA were selected. Unipolar and (converted) bipolar electrograms were analyzed for presence and characteristics of fractionation corresponding to EEA. Sensitivity of presence of EEA corresponding fractionation was high in patients (86–96%) and moderately high (65–78%) for the asynchronous surface area for unipolar and bipolar electrograms equally. In bipolar electrograms, signal-to-noise ratio of EEA corresponding fractionation decreased and additional fractionation increased for electrograms recorded at the endocardium. Sensitivity of fractionation corresponding to EEA is high for both unipolar and bipolar electrograms. Unipolar electrograms are more suited for detection of EEA due to a larger signal-to-noise ratio and less disturbance of additional fractionation.
Graphical Abstract
中文翻译：
使用单极和双极电图检测心房壁心外膜不同步
心外膜不同步（EEA）是一种可能维持心房颤动的新机制。我们旨在确定使用电图分离从心房一侧记录的电图中检测 EEA 的灵敏度和最佳记录方式。选择同时获得的 22 名证明 EEA 的患者的右心房内膜和心外膜电图。分析单极和（转换的）双极电图的存在和对应于 EEA 的分级特征。对于单极和双极电图的异步表面积，患者对 EEA 相应分割存在的敏感性较高（86-96%）和中等高（65-78%）。在双极电图中，在心内膜记录的电图中，EEA 相应分割的信噪比降低，额外分割增加。对于单极和双极电图，对应于 EEA 的分割灵敏度很高。由于更大的信噪比和更少的额外分馏干扰，单极电图更适合检测 EEA。
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