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Simultaneously Collected Monopolar and Discrete Bipolar Electrograms: Comparison of Activation Time Detection Algorithms
Author(s) -
PIEPER CARL F.,
BLUE RUSSELL,
PACIFICO ANTONIO
Publication year - 1993
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 - 10.1111/j.1540-8159.1993.tb01605.x
Subject(s) - algorithm , electrophysiology , medicine , outlier , mathematics , cardiology , statistics
Designation of the time of local activation is fundamental to electrophysiological mapping. In normal myocardium, the minimum slope in extracellular monopolar (MP) electrograms has been linked through simultaneous intraceliular and extracellular recordings to phase 0 of the action potential. However, no similar correlation has been demonstrated for a parameter from bipolar (BP) electrograms. now commonly used during electrophysiological studies and intraopera‐tive mapping. The purpose of this work is to compare the activation time, determined according to several common algorithms applied to BP electrograms, with the time of the minimum slope in MP electrograms. Simultaneous normal epicardial MP and BP electrograms were acquired from sub;ects undergoing surgery for Wolf‐Parlcinson‐White Syndrome and from dogs. The activation time in BP electrograms was defined by four algorithms; (1) peak (P); (2) greatest absolute slope (S); (3) zero crossing of the segment containing the greatest slope (FZC); and (4) morphological (M). Each was compared to the time of the minimum slope in the simultaneously recorded MP response. The incidence of outliers was tabulated. The distribution of activation times computed using each BP algorithm was statistically different from the distribution of activation times derived from MP electrograms. M performed best (absolute difference: 2.6 ± 2.9 msec; cor coef: 0.9925 in man). The M. P, FZC, and S algorithms produced 3.2%, 3.5%, 4.7% and 4.7% outliers, respectively. The overall performance of a morphologically based algorithm is superior fo simplistic BP algorithms hased only on slope or peak.