Multisize Electrode Field-of-View

Multisize Electrode Field-of-View: Validation by High Resolution Gadolinium-Enhanced Cardiac Magnetic Resonance

Omara, Sharif (Leiden University Medical Center)
Glashan, Claire A. (Leiden University Medical Center)
Tofig, Bawer J. (Århus University Hospital)
Leenknegt, Lore (Katholieke Universiteit Leuven)
Dierckx, Hans (Katholieke Universiteit Leuven)
Panfilov, Alexander V. (Universiteit Gent)
Beukers, H.K.C. (Leiden University Medical Center)
Tao, Q. (TU Delft ImPhys/Tao group)
van der Geest, Rob J. (Leiden University Medical Center)

2024

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: In each swine, 220 mapping points (Q1, Q3: 216, 260 mapping points) were collected. Infarcts were heterogeneous and nontransmural. Unipolar and bipolar voltage increased with VM volumes from >175 mm³ up to >525 mm³ (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.

late-gadolinium enhancement
microelectrodes
non-transmural scar
voltage mapping

http://resolver.tudelft.nl/uuid:b1a1736f-caf3-4608-b954-f1d70c7f23c8

https://doi.org/10.1016/j.jacep.2023.12.003

2405-500X

JACC: Clinical Electrophysiology, 10 (4), 637-650

Institutional Repository

journal article

© 2024 Sharif Omara, Claire A. Glashan, Bawer J. Tofig, Lore Leenknegt, Hans Dierckx, Alexander V. Panfilov, H.K.C. Beukers, Q. Tao, Rob J. van der Geest, More Authors