Abstract 17771: Novel Ventricular Voltage Mapping Methodology With Omnipolar Electrograms
Introduction: Variations in bipolar electrogram (EGM) voltage peak-to-peak (Vpp) due to the orientation of bipolar electrodes produce ambiguous bipolar voltage maps. This could lead to erroneous characterization of a myocardium and thus treatment strategy. Using omnipolar EGMs, we can mathematically determine an equivalent bipolar EGM and its Vpp (OTmax) along a wavefront angle-of-incidence (AOI) which, in concept, is the largest bipolar Vpp measurable in any orientation. OTmax can be used to standardize voltage mapping.
Methods: We electrically mappped on four rabbit and two human ventricles using different 2D high density electrode arrays (HD grid and HD plaque). We calculated bipolar EGMs and Vpps from adjacent electrodes in two orientations, horizontal (H) and vertical (V). Bipolar voltage maps were created. To compare, we calculated OTmax within an area enclosed by 4 adjacent electrodes with which we used to create standardized bipolar voltage maps. We quantified both Vpp distributions and consistency of both voltage mapping modalities.
Results: On average, OTmax provides up to 15% and 30% larger Vpps in rabbits and humans, respectively, compared to traditional bipolar EGMs. Furthermore, omnipolar EGM Vpps are relatively more consistent than bipolar EGMs by 40% in rabbit hearts and 56% in human hearts.
Conclusion: Omnipolar EGMs can derive equivalent bipolar EGMs along the wavefront AOI which can be used as a standard method for voltage mapping: one that is not influenced by electrode orientation.
Author Disclosures: K. Magtibay: None. S. Massé: Consultant/Advisory Board; Modest; St. Jude Medical, St. Paul, MN, USA. J. Asta: None. A. Porta-Sanchez: None. S. Haldar: None. D. Malebranche: None. D. Deno: Employment; Significant; St. Jude Medical, St. Paul, MN, USA. K. Nanthakumar: Research Grant; Significant; St. Jude Medical. Consultant/Advisory Board; Significant; St. Jude Medical.
- © 2016 by American Heart Association, Inc.