Author + information
- Received May 26, 2018
- Revision received August 28, 2018
- Accepted August 29, 2018
- Published online January 21, 2019.
- Masateru Takigawa, MD, PhDa,b,∗∗ (, )
- Jatin Relan, MD, PhDa,c,∗,
- Ruairidh Martin, MDa,d,∗,
- Steven Kim, MD, PhDc,
- Takeshi Kitamura, MDa,
- Ghassen Cheniti, MDa,
- Konstantinos Vlachos, MD, PhDa,
- Xavier Pillois, PhDa,
- Antonio Frontera, MDa,
- Grégoire Massoullié, MDa,
- Nathaniel Thompson, MDa,
- Claire A. Martin, MD, PhDa,
- Felix Bourier, MD, PhDa,
- Anna Lam, MDa,
- Michael Wolf, MDa,
- Josselin Duchateau, MDa,
- Nicolas Klotz, MDa,
- Thomas Pambrun, MDa,
- Arnaud Denis, MDa,
- Nicolas Derval, MDa,
- Julie Magat, PhDa,
- Jérôme Naulin, MSca,
- Mathilde Merle, MSca,
- Florent Collot, MSca,
- Bruno Quesson, PhDa,
- Hubert Cochet, MD, PhDa,
- Mélèze Hocini, MDa,
- Michel Haïssaguerre, MDa,
- Frédéric Sacher, MD, PhDa and
- Pierre Jaïs, MDa
- aCHU Bordeaux, IHU Lyric, Université de Bordeaux, Bordeaux, France
- bHeart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan
- cAbbott, St. Paul, Minnesota
- dInstitute of Genetic Medicine, Newcastle University, Newcastle-upon-Tyne, United Kingdom
- ↵∗Address for correspondence:
Dr. Masateru Takigawa, CHU Bordeaux, IHU Lyric, Université de Bordeaux, Avenue de Magellan, 33604 Bordeaux-Pessac, France.
Objectives This study sought to evaluate the relation between bipolar electrode spacing and far- and near-field electrograms.
Background The detailed effects of bipolar spacing on electrograms (EGMs) is not well described.
Methods With a HD-Grid catheter, EGMs from different bipole pairs could be created in each acquisition. This study analyzed the effect of bipolar spacing on EGMs in 7 infarcted sheep. A segment was defined as a 2-mm center-to-center bipole. In total, 4,768 segments (2,020 healthy, 1,542 scar, and 1,206 in border areas, as defined by magnetic resonance imaging [MRI]) were covered with an electrode pair of spacing of 2 mm (Bi-2), 4 mm (Bi-4), and 8 mm (Bi-8).
Results A total of 3,591 segments in Bi-2 were free from local abnormal ventricular activities (LAVAs); 1,630 segments were within the MRI-defined scar and/or border area. Among them, 172 (10.6%) segments in Bi-4 and 219 (13.4%) segments in Bi-8 showed LAVAs. In contrast, LAVAs were identified in 1,177 segments in Bi-2; 1,118 segments were within the MRI-defined scar and/or border area. Among them, LAVAs were missed in 161 (14.4%) segments in Bi-4 and in 409 (36.6%) segments in Bi-8. In segments with LAVAs, median far-field voltage increased from 0.09 mV (25th to 75th percentile: 0.06 to 0.14 mV) in Bi-2, to 0.16 mV (25th to 75th percentile: 0.10 to 0.24 mV) in Bi-4, and to 0.28 mV (25th to 75th percentile: 0.20 to 0.42 mV) in Bi-8 (p < 0.0001). Median near-field voltage increased from 0.14 mV (25th to 75th percentile: 0.08 to 0.25 mV) in Bi-2, to 0.21 mV (25th to 75th percentile: 0.12 to 0.35 mV) in Bi-4, and to 0.32 mV (25th to 75th percentile: 0.17 to 0.48 mV) in Bi-8 (p < 0.0001). The median near-/far-field voltage ratio decreased from 1.67 in Bi-2, to 1.43 in Bi-4, and 1.23 in Bi-8 (p < 0.0001).
Conclusions Closer spacing better discriminates surviving tissue from dead scar area. Although far-field voltage systematically increases with spacing, near-field voltages were more variable, depending on local surviving muscular bundles. Near-field EGMs are more easily observed with smaller spacing, largely due to the reduction of the far-field effect.
↵∗ Drs. Takigawa, Relan, and Martin contributed equally to this work and are joint first authors.
This study was supported by Equipex MUSIC ANR-11-EQPX-0030, IHU LIRYC ANR-10-IAHU-04, and a research grant from Abbott. Drs. Haïssaguerre, Hocini, Jaïs, and Sacher have received lecture fees from Biosense Webster and Abbott; and Drs. Denis, Derval, Jaïs, and Sacher have received speaking honoraria/consulting fees from Boston Scientific. Mrs. Jatin and Mrs. Kim are Employees of Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
All authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Clinical Electrophysiology author instructions page.
- Received May 26, 2018.
- Revision received August 28, 2018.
- Accepted August 29, 2018.
- 2019 American College of Cardiology Foundation
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