ArticlePLoS computational biology2019
Multiple factors influence the morphology of the bipolar electrogram: An in silico modeling study.
Article in PLoS computational biology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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Who cites it
17 citing papers in PubMed.
- Clinical Outcomes of Computational Virtual Mapping-Guided Catheter Ablation in Patients With Persistent Atrial Fibrillation: A Multicenter Prospective Randomized Clinical Trial.Frontiers in cardiovascular medicine · 2021Trial
- Peak frequency can be effectively used to characterize scar in atrial fibrillation.Heart rhythm O2 · 2025Article
- Anti- and pro-fibrillatory effects of pulmonary vein isolation gaps in human atrial fibrillation digital twins.NPJ digital medicine · 2024Article
- A single-beat algorithm to discriminate farfield from nearfield bipolar voltage electrograms from the pulmonary veins.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2023Article
- Ventricular Electrograms Duration Map to Detect Ventricular Arrhythmia Substrate: the VEDUM Project Study.Circulation. Arrhythmia and electrophysiology · 2023Article
- An Efficient Hybrid Methodology for Local Activation Waves Detection under Complex Fractionated Atrial Electrograms of Atrial Fibrillation.Sensors (Basel, Switzerland) · 2022Article
- Restitution Slope Affects the Outcome of Dominant Frequency Ablation in Persistent Atrial Fibrillation: CUVIA-AF2Frontiers in cardiovascular medicine · 2022Article
- Anti-atrial Fibrillation Effects of Pulmonary Vein Isolation With or Without Ablation Gaps: A Computational Modeling Study.Frontiers in physiology · 2022Article
- A Review of Healthy and Fibrotic Myocardium Microstructure Modeling and Corresponding Intracardiac Electrograms.Frontiers in physiology · 2022Review
- Ablation and antiarrhythmic drug effects onFrontiers in cardiovascular medicine · 2022Article
- Increased body mass index, age, and left atrial size are associated with altered intracardiac atrial electrograms in persistent atrial fibrillation patients.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2021Article
- Spatial Changes in the Atrial Fibrillation Wave-Dynamics After Using Antiarrhythmic Drugs: A Computational Modeling Study.Frontiers in physiology · 2021Article
- Using Machine Learning to Characterize Atrial Fibrotic Substrate From Intracardiac Signals With a HybridFrontiers in physiology · 2021Article
- Computational Modeling for Antiarrhythmic Drugs for Atrial Fibrillation According to Genotype.Frontiers in physiology · 2021Article
- Computational Analysis of Mapping Catheter Geometry and Contact Quality Effects on Rotor Detection in Atrial Fibrillation.Frontiers in physiology · 2021Article
- In situ procedure for high-efficiency computational modeling of atrial fibrillation reflecting personal anatomy, fiber orientation, fibrosis, and electrophysiology.Scientific reports · 2020Article
- Impact of recording technologies on cardiac electrogram morphology: implications for mapping and interpretation.Indian pacing and electrophysiology journalReview
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Authors and funding
7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
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 an in 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<0.001), lower for a 90° than 0° CA (p<0.001), and lower for a CV of 0.13m/s than 0.48m/s (p<0.001). Larger sized non-conductive areas were associated with a decreased bipolar amplitude (p<0.001) and increased bipolar width (p<0.001). Among three commercially available catheters (Orion, Pentaray, and Thermocool), those with more narrowly spaced and smaller electrodes produced higher voltages on the virtual Bi-egms (p<0.001). Multiple factors including the CO, CA, CV, and catheter design significantly influence the Bi-egm morphology. Universal voltage cut-off values may not be appropriate for bipolar voltage-guided substrate mapping.
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