Effect of electrode size and spacing on electrograms: Optimized electrode configuration for near-field electrogram characterization,Heart Rhythm

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Effect of electrode size and spacing on electrograms: Optimized electrode configuration for near-field electrogram characterization
Heart Rhythm ( IF 5.6 ) Pub Date : 2021-09-14 , DOI: 10.1016/j.hrthm.2021.09.011
Masateru Takigawa ₁ , Takeshi Kitamura ₂ , Shubhayu Basu ₃ , Meir Bartal ₄ , Claire A Martin ₅ , Ruairidh Martin ₆ , Ghassen Cheniti ₂ , Konstantinos Vlachos ₂ , Xavier Pillois ₂ , Antonio Frontera ₂ , Grégoire Massoullié ₂ , Nathaniel Thompson ₂ , Felix Bourier ₂ , Anna Lam ₂ , Josselin Duchateau ₂ , Thomas Pambrun ₂ , Arnaud Denis ₂ , Nicolas Derval ₂ , Hubert Cochet ₂ , Michel Haïssaguerre ₂ , Frederic Sacher ₂ , Mélèze Hocini ₂ , Pierre Jaïs ₂

Affiliation

Background

Detailed effects of electrode size on electrograms (EGMs) have not been systematically examined.

Objectives

We aimed to elucidate the effect of electrode size on EGMs and investigate an optimal configuration of electrode size and interelectrode spacing for gap detection and far-field reduction.

Methods

This study included 8 sheep in which probes with different electrode size and interelectrode spacing were epicardially placed on healthy, fatty, and lesion tissues for measurements. Between 3 electrode sizes (0.1 mm/0.2 mm/0.5 mm) with 3 mm spacing. As indices of capability in gap detection and far-field reduction, in different electrode sizes (0.1 mm/0.2 mm/0.5 mm) and interelectrode spacing (0.1 mm/0.2 mm/0.3 mm/0.5 mm/3 mm) and the optimized electrode size and interelectrode spacing were determined. Compared between PentaRay and the optimal probe determined in study 2.

Results

Study 1 demonstrated that unipolar voltage and the duration of EGMs increased as the electrode size increased in any tissue (P < .001). Bipolar EGMs had the same tendency in healthy/fat tissues, but not in lesions. Study 2 showed that significantly higher gap to lesion volume ratio and healthy to fat tissue voltage ratio were provided by a smaller electrode (0.2 mm or 0.3 mm electrode) and smaller spacing (0.1 mm spacing), but 0.3 mm electrode/0.1 mm spacing provided a larger bipolar voltage (P < .05). Study 3 demonstrated that 0.3 mm electrode/0.1 mm spacing provided less deflection with more discrete EGMs (P < .0001) with longer and more reproducible AF cycle length (P < .0001) compared to PentaRay.

Conclusion

Electrode size affects both unipolar and bipolar EGMs. Catheters with microelectrodes and very small interelectrode spacing may be superior in gap detection and far-field reduction. Importantly, this electrode configuration could dramatically reduce artifactual complex fractionated atrial electrograms and may open a new era for AF mapping.

中文翻译：

电极尺寸和间距对电图的影响：用于近场电图表征的优化电极配置

背景

尚未系统地检查电极尺寸对电图 (EGM) 的详细影响。

目标

我们旨在阐明电极尺寸对 EGM 的影响，并研究用于间隙检测和远场减少的电极尺寸和电极间距的最佳配置。

方法

这项研究包括 8 只绵羊，其中将具有不同电极尺寸和电极间距的探针在心外膜上放置在健康、脂肪和病变组织上进行测量。3 种电极尺寸（0.1 毫米/0.2 毫米/0.5 毫米）之间，间距为 3 毫米。作为间隙检测和远场减小能力的指标，在不同的电极尺寸（0.1 mm/0.2 mm/0.5 mm）和电极间距（0.1 mm/0.2 mm/0.3 mm/0.5 mm/3 mm）和优化电极尺寸和电极间距确定。PentaRay 与研究 2 中确定的最佳探头之间的比较。

结果

研究 1 表明，单极电压和 EGM 的持续时间随着任何组织中电极尺寸的增加而增加 ( P < .001)。双极 EGM 在健康/脂肪组织中具有相同的趋势，但在病变中没有。研究 2 表明，较小的电极（0.2 mm 或 0.3 mm 电极）和较小的间距（0.1 mm 间距）提供了显着更高的间隙与病灶体积比和健康与脂肪组织电压比，但提供了 0.3 mm 电极/0.1 mm 间距较大的双极电压 ( P < .05)。研究 3 表明，与 PentaRay 相比，0.3 mm 电极/0.1 mm 间距可提供更少的偏转，具有更多离散的 EGM ( P < .0001)，具有更长和更可重复的 AF 周期长度 ( P < .0001)。