Key result
Cross-configuration cliques with ≤ 2 mm spacing yield more reliable oEGM estimations versus triangular cliques.
Why the study?
High-density catheters combined with orientation-independent sensing are used for cardiac substrate characterisation, but the arrangements and constraints required to reliably estimate omnipolar electrograms needed assessment.
Does a cross-orientation clique arrangement improve the estimation of omnipolar electrograms compared to classic triangular cliques in high-density electrode arrays?
Does a cross-orientation clique arrangement improve the estimation of omnipolar electrograms compared to classic triangular cliques in high-density electrode arrays?
Cross-orientation clique arrangements with interelectrode spacing ≤ 1 mm provide more reliable omnipolar electrogram estimations than classic triangular cliques, suggesting current techniques are insufficiently accurate.
May enhance omnipolar electrogram reliability in animal models; leaves open translation to clinical high-density mapping.
High-density catheters combined with Orientation Independent Sensing (OIS) methods have emerged as a groundbreaking technology for cardiac substrate characterisation. In this study, we aim to assess the arrangements and constraints to reliably estimate the so-called omnipolar electrogram (oEGM). Performance was evaluated using an experimental animal model. Thirty-eight recordings from nine retrospective experiments on isolated perfused rabbit hearts with an epicardial HD multielectrode were used. We estimated oEGMs according to the classic triangular clique (4 possible orientations) and a novel cross-orientation clique arrangement. Furthermore, we tested the effects of interelectrode spacing from 1 to 4 mm. Performance was evaluated by means of several parameters that measured amplitude rejection ratios, electric field loop area, activation pulse width and morphology distortion. Most reliable oEGM estimations were obtained with cross-configurations and interelectrode spacings [Formula: see text] mm. Estimations from triangular cliques resulted in wider electric field loops and unreliable detection of the direction of the propagation wavefront. Moreover, increasing interelectrode distance resulted in increased pulse width and morphology distortion. The results prove that current oEGM estimation techniques are insufficiently accurate. This study opens a new standpoint for the design of new-generation HD catheters and mapping software.
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Ruipérez-Campillo et al. (2023) studied Cardiac electrophysiology (n=9). Cross-orientation clique arrangement vs. Classic triangular clique arrangement was evaluated on Reliability of omnipolar electrogram (oEGM) estimations measured by amplitude rejection ratios, electric field loop area, activation pulse width, and morphology distortion. Cross-configuration cliques with interelectrode spacing ≤ 2 mm provided the most reliable omnipolar electrogram estimations compared to triangular cliques in an experimental animal model.
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