Premium
Single Catheter Determination of Local Electrogram Prematurity Using Simultaneous Unipolar and Bipolar Recordings to Replace the Surface ECG as a Timing Reference
Author(s) -
DELACRETAZ ETIENNE,
SOEJIMA KYOKO,
GOTTIPATY VENKATESHWAR K.,
BRUNCKHORST CORINNA B.,
FRIEDMAN PETER L.,
STEVENSON WILLIAM G.
Publication year - 2001
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1046/j.1460-9592.2001.00441.x
Subject(s) - medicine , ablation , qrs complex , cardiology , ventricular tachycardia , rf ablation , catheter ablation , tachycardia , cardiac ablation
DELACRETAZ, E., et al. : Single Catheter Determination of Local Electrogram Prematurity Using Simultaneous Unipolar and Bipolar Recordings to Replace the Surface ECG as a Timing Reference. 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 (30–500Hz) were analyzed. The interval between the onset of the minimally filtered unipolar electrogram and the first peak of the bipolar electrogram (Uni On ‐ Bi p ) 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, Uni On ‐ Bi P was shorter at successful compared to unsuccessful sites ( 3.8 ± 3.5 vs 9.2 ± 5.2ms, 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.