Dataset Information

Characterization of unipolar electrogram morphology: a novel tool for quantifying conduction inhomogeneity.

ABSTRACT:

Aims

Areas of conduction inhomogeneity (CI) during sinus rhythm (SR) may facilitate initiation and perpetuation of atrial fibrillation (AF). Currently, no tool is available to quantify the severity of conduction inhomogeneity. Our purpose is to develop and validate a novel tool using unipolar electrograms (EGMs) only to quantify the severity of conduction inhomogeneity in the atria.

Methods and results

Epicardial mapping of the right (RA) and left atrium, including Bachmann's bundle was performed in 235 patients undergoing coronary artery bypass grafting surgery. CI was defined as the amount of conduction block. EGMs were classified as single-, short- and long double -(LDP) and fractionated potentials (FP), and the fractionation duration (FD) of non-single potentials was measured. The proportion of low-voltage areas (LVA, < 1 mV) was calculated. Increased CI was associated with decreased potential voltages and increased LVAs, LDPs and FPs. The Electrical Fingerprint Score consisting of RA EGMs features, including LVAs and LDPs, was most accurate in predicting CI severity. The RA Electrical Fingerprint Score demonstrated the highest correlation with the amount of CI in both atria (r = 0.70, p < 0.001).

Conclusion

The Electrical Fingerprint Score is a novel tool to quantify severity of CI using only unipolar EGMs characteristics recorded. This tool can be used to stage the degree of conduction abnormalities without construction of spatial activation patterns, potentially enabling early identification of patients at high risk of post-operative AF or selection of the appropriate ablation approach in addition to pulmonary vein isolation at the EP lab.

SUBMITTER: Ye Z

PROVIDER: S-EPMC10657215 | biostudies-literature | 2023 Nov

REPOSITORIES: biostudies-literature

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Publications

Characterization of unipolar electrogram morphology: a novel tool for quantifying conduction inhomogeneity.

Ye Ziliang Z van Schie Mathijs S MS Pool Lisa L Heida Annejet A Knops Paul P Taverne Yannick J H J YJHJ Brundel Bianca J J M BJJM de Groot Natasja M S NMS de Groot Natasja M S NMS

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 20231101 11

<h4>Aims</h4>Areas of conduction inhomogeneity (CI) during sinus rhythm may facilitate the initiation and perpetuation of atrial fibrillation (AF). Currently, no tool is available to quantify the severity of CI. Our aim is to develop and validate a novel tool using unipolar electrograms (EGMs) only to quantify the severity of CI in the atria.<h4>Methods and results</h4>Epicardial mapping of the right atrium (RA) and left atrium, including Bachmann's bundle, was performed in 235 patients undergoi ...[more]

PMID: 37931071

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Project description:BackgroundIt is unknown which features of unipolar atrial electrogram (U-AEGM) morphology are affected by ageing and whether age-related changes in U-AEGM morphology are equally distributed throughout the right and left atria.Patients and methodsEpicardial high-resolution mapping was performed in patients undergoing coronary artery bypass grafting surgery during sinus rhythm (SR). Mapping areas include the right atrium (RA), left atrium (LA), pulmonary vein area (PVA) and Bachmann's bundle (BB). Patients were categorized into a young (age < 60) and aged (age ≥ 60) group. U-AEGM were classified as single potentials (SPs, one deflection), short double potentials (SDPs, deflection interval ≤ 15ms), long double potentials (LDPs, deflection interval > 15ms) and fractionated potentials (FPs, ≥3 deflections).ResultsA total of 213 patients (age: 67 (59-73) years; young group N = 58, aged group N = 155) were included. Only at BB, the proportion of SPs (p = 0.007) was significantly higher in the young group, while the proportion of SDPs (p = 0.051), LDPs (p = 0.004) and FPs (p = 0.006) was higher in the aged group. After adjusting for potential confounders, older age was associated with a reduction in SPs [regression coefficient (β): -6.33, 95% confident interval (CI): -10.37 to -2.30] at the expense of an increased proportion of SDPs (β: 2.49, 95% CI: 0.09 to 4.89), LDPs (β: 1.94, 95% CI: 0.21 to 3.68) and FPs (β: 1.90, 95% CI: 0.62 to 3.18).ConclusionsAge-related remodeling particularly affects BB as indicated by the decreased amount of non-SP at this location in the elderly.Key MessagesAgeing preferentially affects the morphology of unipolar atrial electrograms recorded at Bachmann's bundle.At Bachmann's bundle, the proportion of short double-, long double- and fractionated potentials increase during ageing at the expense of a decrease in the proportion of single potentials, reflecting aggravation of abnormalities in conduction.The increase in abnormal unipolar atrial electrograms at Bachmann's bundle during ageing supports the concept that Bachmann's bundle may play an important role in development of age-related arrhythmias such as atrial fibrillation.

Dataset Information

Characterization of unipolar electrogram morphology: a novel tool for quantifying conduction inhomogeneity.

Aims

Methods and results

Conclusion

Publications

Characterization of unipolar electrogram morphology: a novel tool for quantifying conduction inhomogeneity.

Similar Datasets

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