CHU Bordeaux, IHU LIRYC, Université de Bordeaux, Bordeaux, France; Heart Rhythm Center, Tokyo Medical and Dental University, Tokyo, Japan.
CHU Bordeaux, IHU LIRYC, Université de Bordeaux, Bordeaux, France.
Heart Rhythm. 2022 Jan;19(1):102-112. doi: 10.1016/j.hrthm.2021.09.011. Epub 2021 Sep 14.
Detailed effects of electrode size on electrograms (EGMs) have not been systematically examined.
We aimed to elucidate the effect of electrode size on EGMs and investigate an optimal configuration of electrode size and interelectrode spacing for gap detection and far-field reduction.
This study included 8 sheep in which probes with different electrode size and interelectrode spacing were epicardially placed on healthy, fatty, and lesion tissues for measurements. Between 3 electrode sizes (0.1 mm/0.2 mm/0.5 mm) with 3 mm spacing. As indices of capability in gap detection and far-field reduction, in different electrode sizes (0.1 mm/0.2 mm/0.5 mm) and interelectrode spacing (0.1 mm/0.2 mm/0.3 mm/0.5 mm/3 mm) and the optimized electrode size and interelectrode spacing were determined. Compared between PentaRay and the optimal probe determined in study 2.
Study 1 demonstrated that unipolar voltage and the duration of EGMs increased as the electrode size increased in any tissue (P < .001). Bipolar EGMs had the same tendency in healthy/fat tissues, but not in lesions. Study 2 showed that significantly higher gap to lesion volume ratio and healthy to fat tissue voltage ratio were provided by a smaller electrode (0.2 mm or 0.3 mm electrode) and smaller spacing (0.1 mm spacing), but 0.3 mm electrode/0.1 mm spacing provided a larger bipolar voltage (P < .05). Study 3 demonstrated that 0.3 mm electrode/0.1 mm spacing provided less deflection with more discrete EGMs (P < .0001) with longer and more reproducible AF cycle length (P < .0001) compared to PentaRay.
Electrode size affects both unipolar and bipolar EGMs. Catheters with microelectrodes and very small interelectrode spacing may be superior in gap detection and far-field reduction. Importantly, this electrode configuration could dramatically reduce artifactual complex fractionated atrial electrograms and may open a new era for AF mapping.
电极大小对电图（EGM）的详细影响尚未系统地进行检查。
本研究旨在阐明电极大小对 EGM 的影响，并研究电极大小和电极间距的最佳配置，以用于检测缝隙和减少远场。
本研究纳入 8 只绵羊，在健康、脂肪和病变组织上心外膜放置具有不同电极大小和电极间距的探头进行测量。在 3 种电极大小（0.1mm/0.2mm/0.5mm）和 3mm 间距下。作为检测缝隙和远场减少能力的指标，在不同的电极大小（0.1mm/0.2mm/0.5mm）和电极间距（0.1mm/0.2mm/0.3mm/0.5mm/3mm）下确定了优化的电极大小和电极间距，并与研究 2 中确定的 PentaRay 进行了比较。
研究 1 表明，在任何组织中，随着电极尺寸的增大，单极电压和 EGM 持续时间均增加（P<0.001）。健康/脂肪组织中的双极 EGM 也有相同的趋势，但病变组织中没有。研究 2 表明，较小的电极（0.2mm 或 0.3mm 电极）和较小的间距（0.1mm 间距）提供了更高的缝隙到病变体积比和健康到脂肪组织电压比，但 0.3mm 电极/0.1mm 间距提供了更大的双极电压（P<0.05）。研究 3 表明，与 PentaRay 相比，0.3mm 电极/0.1mm 间距提供的偏转更小，EGM 更离散（P<0.0001），AF 周期长度更长且更可重复（P<0.0001）。
电极大小会影响单极和双极 EGM。具有微电极和非常小的电极间距的导管在检测缝隙和减少远场方面可能更优越。重要的是，这种电极配置可以显著减少人为的复杂碎裂心房电图，并可能为 AF 映射开辟一个新时代。
