Evaluation of an alternative triangular clique for omnipolar electrogram estimation

The accurate characterization of intracardiac substrate is essential when identifying and characterizing ablation sites. Omnipolar electrograms (oEGMs) have emerged as an alternative to unipolar and bipolar configurations, providing a local voltage measurement independent of wavefront propagation direction and free from artifacts. However, it has been proven that their effectiveness depends certain factors, such as the electrode geometry. This study evaluates a novel triangular clique configuration with equispaced electrodes for oEGM estimation, based on a recently patented high-density multi-electrode catheter. A set of unipolar signals and a 2D simulation environment were used, ensuring conditions of planarity and homogeneity, to compare the performance of the novel clique against the standard triangular configuration. The estimated electrical fields have shown a narrower loop, demonstrating a lower sensitivity to certain propagation directions. Significant reductions (p < 0.05) in the LAT detection error and the amount of residual signal inherent to the oEGM were observed, indicating that the proposed clique provides more consistent results.Clinical Relevance- This advancement holds potential for improving cardiac mapping resolution and guiding ablation therapy in arrhythmia treatment.