Multiple factors influence the morphology of the bipolar electrogram: An < i > in silico < /i > modeling study

by Minki Hwang, Jaehyuk Kim, Byounghyun Lim, Jun-Seop Song, Boyoung Joung, Eun Bo Shim, Hui-Nam Pak Although bipolar electrograms (Bi-egms) are commonly used for catheter mapping and ablation of cardiac arrhythmias, the accuracy and reproducibility of Bi-egms have not been evaluated. We aimed to clarify the influence of the catheter orientation (CO), catheter contact angle (CA), local conduction velocity (CV), scar size, and catheter type on the Bi-egm morphology using anin silico 3-dimensional realistic model of atrial fibrillation. We constructed a 3-dimensional, realistic,in silico left atrial model with activation wave propagation including bipolar catheter models. Bi-egms were obtained by computing the extracellular potentials from the distal and proximal electrodes. The amplitude and width were measured on virtual Bi-egms obtained under different conditions created by changing the CO according to the wave direction, catheter-atrial wall CA, local CV, size of the non-conductive area, and catheter type. Bipolar voltages were also compared between virtual and clinically acquired Bi-egms. Bi-egm amplitudes were lower for a perpendicular than parallel CO relative to the wave direction (p
Source: PLoS Computational Biology - Category: Biology Authors: Source Type: research