Multisize Electrode Field-of-View

JACC. Clinical electrophysiology, vol. 10, pp. 637–650

Abstract

BACKGROUND: Voltage mapping to detect ventricular scar is important for guiding catheter ablation, but the field-of-view of unipolar, bipolar, conventional, and microelectrodes as it relates to the extent of viable myocardium (VM) is not well defined. OBJECTIVES: The purpose of this study was to evaluate electroanatomic voltage-mapping (EAVM) with different-size electrodes for identifying VM, validated against high-resolution ex-vivo cardiac magnetic resonance (HR-LGE-CMR). METHODS: A total of 9 swine with early-reperfusion myocardial infarction were mapped with the QDOT microcatheter. HR-LGE-CMR (0.3-mm slices) were merged with EAVM. At each EAVM point, the underlying VM in multisize transmural cylinders and spheres was quantified from ex vivo CMR and related to unipolar and bipolar voltages recorded from conventional and microelectrodes. RESULTS: (equivalent to a 5-mm radius cylinder with height >6.69 mm). VM volumes in subendocardial cylinders with 1- or 3-mm depth correlated poorly with all voltages. Unipolar voltages recorded with conventional and microelectrodes were similar (difference 0.17 ± 2.66 mV) and correlated best to VM within a sphere of radius 10 and 8 mm, respectively. Distance-weighting did not improve the correlation. CONCLUSIONS: Voltage increases with transmural volume of VM but correlates poorly with small amounts of VM, which limits EAVM in defining heterogeneous scar. Microelectrodes cannot distinguish thin from thick areas of subendocardial VM. The field-of-view for unipolar recordings for microelectrodes and conventional electrodes appears to be 8 to 10 mm, respectively, and unexpectedly similar.

Authors 14

1. Sharif Omara Aachen Department of Cardiology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark; Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands

   Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands

   Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark

2. Claire A. Glashan Aachen Department of Cardiology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark; Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands

   Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands

   Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark

3. Bawer Jalal Tofig

   Aarhus University Hospital

   Affiliation as printed

   Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

   Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

   Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark

4. Lore Leenknegt

   KU Leuven

   Affiliation as printed

   Department of Mathematics, KU Leuven campus Kortrijk, Kortrijk, Belgium

5. Hans Dierckx

   KU Leuven

   Affiliation as printed

   Department of Mathematics, KU Leuven campus Kortrijk, Kortrijk, Belgium

6. Alexander V. Panfilov

   Ghent University

   Affiliation as printed

   Department of Physics and Astronomy, Ghent University, Ghent, Belgium

7. Michiel H. van Waasbergen Aachen Department of Cardiology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands

8. Qian Tao

   Delft University of Technology

   Affiliation as printed

   Department of Imaging Physics, Delft University of Technology, Delft, the Netherlands

9. William G. Stevenson

   Vanderbilt University · Vanderbilt University Medical Center

   Affiliation as printed

   Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA

10. Jens Cosedis Nielsen

    Aarhus University Hospital

    Affiliation as printed

    Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

    Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

    Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark

11. Peter Lukáč

    Aarhus University Hospital

    Affiliation as printed

    Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

    Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

    Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark

12. Steen Buus Kristiansen

    Aarhus University Hospital

    Affiliation as printed

    Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

    Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

    Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark

13. Rob J. van der Geest Aachen Department of Radiology Division of Image Processing (LKEB)

    Leiden University Medical Center

    Affiliation as printed

    Department of Radiology, Division of Image Processing, Leiden University Medical Center, Leiden, the Netherlands

14. Katja Zeppenfeld corresponding Aachen Department of Cardiology, Leiden University Medical Center

    Leiden University Medical Center · Aarhus University Hospital

    Affiliation as printed

    Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark; Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands; Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark. Electronic address: k.zeppenfeld@lumc.nl

    Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

    Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands

    Willem Einthoven Center for Cardiac Arrhythmia Research and Management, Leiden, the Netherlands, and Aarhus, Denmark