Pace mapping using three bipolar electrograms from widely spaced electrodes significantly improved spatial resolution compared to surface electrocardiograms (6.1 mm vs 9.9 mm, p=0.012).
Cross-Sectional (n=15)
Single-blind
Randomized pacing order
No
Does the use of bipolar electrograms from widely spaced electrodes improve the spatial resolution of pace mapping in the atrium compared to surface electrocardiograms in patients undergoing electrophysiology study?
The use of widely spaced bipolar electrograms significantly improves the spatial resolution of atrial pace mapping compared to standard 12-lead surface ECGs.
Absolute Event Rate: 6.1% vs 9.9%
p-value: p=0.012
BACKGROUND: Pace mapping is a useful tool but is of limited utility for the atrium because of poor spatial resolution. We investigated the use of bipolar electrograms recorded from widely spaced electrodes in order to improve the resolution of pace mapping. METHODS: This prospective study included patients undergoing a clinical electrophysiology study. Unipolar pacing from either the superior or inferior lateral right atrium was performed to simulate atrial tachycardia. Twelve-lead electrocardiograms were recorded during pacing as a template. In addition, three intracardiac bipolar electrograms from a set of widely spaced electrodes were also recorded. Subsequently, unipolar pacing was performed from electrodes at known distances from the initial pacing site, and the morphology of P waves in the electrocardiogram and bipolar electrograms were compared with that of the template. Morphological comparison was performed by a cardiologist and by automated computerized matching. Spatial resolution was calculated as the minimum distance at which there was no match. RESULTS: Fifteen patients participated in the study. Distance at which differences in morphology were noted was smaller in the bipolar electrograms compared to that indicated by P waves in the electrocardiogram, when matched by the cardiologist (6.1±3.8 mm vs. 9.9±5.2 mm, p=0.012) or by automated analysis (4±0 mm vs. 9.9±4 mm, p<0.001). CONCLUSIONS: Use of three bipolar electrograms recorded from a set of widely spaced electrodes in the right atrium improves the resolution of pace mapping compared to that using P waves from surface electrocardiograms alone.
Selvaraj et al. (Fri,) conducted a cross-sectional in Patients undergoing clinical electrophysiology study (n=15). Pace mapping using bipolar electrograms from widely spaced electrodes vs. Pace mapping using P waves from 12-lead surface electrocardiograms was evaluated on Spatial resolution of pace mapping (minimum distance at which there was no match) using manual matching (p=0.012). Pace mapping using three bipolar electrograms from widely spaced electrodes significantly improved spatial resolution compared to surface electrocardiograms (6.1 mm vs 9.9 mm, p=0.012).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: