Atrial substrate characterization based on bipolar voltage electrograms acquired with multipolar, focal and mini-electrode catheters

Abstract Background Bipolar voltage (BV) electrograms for left atrial (LA) substrate characterization depend on catheter design and electrode configuration. Aims The aim of the study was to investigate the relationship between the BV amplitude (BVA) using four catheters with different electrode desi...

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Veröffentlicht in:	Europace (London, England) England), 2023-05, Vol.25 (5)
Hauptverfasser:	Knecht, Sven, Schlageter, Vincent, Badertscher, Patrick, Krisai, Philipp, Jousset, Florian, Küffer, Thomas, Madaffari, Antonio, Schaer, Beat, Osswald, Stefan, Sticherling, Christian, Kühne, Michael
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creator	Knecht, Sven Schlageter, Vincent Badertscher, Patrick Krisai, Philipp Jousset, Florian Küffer, Thomas Madaffari, Antonio Schaer, Beat Osswald, Stefan Sticherling, Christian Kühne, Michael
description	Abstract Background Bipolar voltage (BV) electrograms for left atrial (LA) substrate characterization depend on catheter design and electrode configuration. Aims The aim of the study was to investigate the relationship between the BV amplitude (BVA) using four catheters with different electrode design and to identify their specific LA cutoffs for scar and healthy tissue. Methods and results Consecutive high-resolution electroanatomic mapping was performed using a multipolar-minielectrode Orion catheter (Orion-map), a duo-decapolar circular mapping catheter (Lasso-map), and an irrigated focal ablation catheter with minielectrodes (Mifi-map). Virtual remapping using the Mifi-map was performed with a 4.5 mm tip-size electrode configuration (Nav-map). BVAs were compared in voxels of 3 × 3 × 3 mm3. The equivalent BVA cutoff for every catheter was calculated for established reference cutoff values of 0.1, 0.2, 0.5, 1.0, and 1.5 mV. We analyzed 25 patients (72% men, age 68 ± 15 years). For scar tissue, a 0.5 mV cutoff using the Nav corresponds to a lower cutoff of 0.35 mV for the Orion and of 0.48 mV for the Lasso. Accordingly, a 0.2 mV cutoff corresponds to a cutoff of 0.09 mV for the Orion and of 0.14 mV for the Lasso. For healthy tissue cutoff at 1.5 mV, a larger BVA cutoff for the small electrodes of the Orion and the Lasso was determined of 1.68 and 2.21 mV, respectively. Conclusion When measuring LA BVA, significant differences were seen between focal, multielectrode, and minielectrode catheters. Adapted cutoffs for scar and healthy tissue are required for different catheters. Graphical Abstract Graphical abstract Pipeline of the analysis leading to the individual cutoff for every catheter based on the reference catheter value: Color-coded consecutive voltage mapping using the Orion, Lasso, Mifi, and Nav catheter in 3D (x–y–z in mm) results after processing in the BVA cutoff values for an individual catheter type.
doi_str_mv	10.1093/europace/euad127
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Aims The aim of the study was to investigate the relationship between the BV amplitude (BVA) using four catheters with different electrode design and to identify their specific LA cutoffs for scar and healthy tissue. Methods and results Consecutive high-resolution electroanatomic mapping was performed using a multipolar-minielectrode Orion catheter (Orion-map), a duo-decapolar circular mapping catheter (Lasso-map), and an irrigated focal ablation catheter with minielectrodes (Mifi-map). Virtual remapping using the Mifi-map was performed with a 4.5 mm tip-size electrode configuration (Nav-map). BVAs were compared in voxels of 3 × 3 × 3 mm3. The equivalent BVA cutoff for every catheter was calculated for established reference cutoff values of 0.1, 0.2, 0.5, 1.0, and 1.5 mV. We analyzed 25 patients (72% men, age 68 ± 15 years). For scar tissue, a 0.5 mV cutoff using the Nav corresponds to a lower cutoff of 0.35 mV for the Orion and of 0.48 mV for the Lasso. Accordingly, a 0.2 mV cutoff corresponds to a cutoff of 0.09 mV for the Orion and of 0.14 mV for the Lasso. For healthy tissue cutoff at 1.5 mV, a larger BVA cutoff for the small electrodes of the Orion and the Lasso was determined of 1.68 and 2.21 mV, respectively. Conclusion When measuring LA BVA, significant differences were seen between focal, multielectrode, and minielectrode catheters. Adapted cutoffs for scar and healthy tissue are required for different catheters. Graphical Abstract Graphical abstract Pipeline of the analysis leading to the individual cutoff for every catheter based on the reference catheter value: Color-coded consecutive voltage mapping using the Orion, Lasso, Mifi, and Nav catheter in 3D (x–y–z in mm) results after processing in the BVA cutoff values for an individual catheter type.</description><identifier>ISSN: 1099-5129</identifier><identifier>ISSN: 1532-2092</identifier><identifier>EISSN: 1532-2092</identifier><identifier>DOI: 10.1093/europace/euad127</identifier><identifier>PMID: 37165671</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Clinical Research</subject><ispartof>Europace (London, England), 2023-05, Vol.25 (5)</ispartof><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology. 2023</rights><rights>The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c433t-f17b8cd659aa311bb627c85dd2403995e1c13f0404fb3208ee21271ea6561c593</citedby><cites>FETCH-LOGICAL-c433t-f17b8cd659aa311bb627c85dd2403995e1c13f0404fb3208ee21271ea6561c593</cites><orcidid>0000-0002-0807-4827 ; 0000-0001-9751-0557 ; 0000-0001-8364-3279 ; 0000-0001-7122-021X ; 0000-0003-1768-1968 ; 0000-0002-4367-2363 ; 0000-0001-8428-7050 ; 0000-0003-3553-4945 ; 0000-0001-6305-5103 ; 0000-0002-2937-3711 ; 0000-0002-9240-6731</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228606/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228606/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,885,1604,27924,27925,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37165671$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Knecht, Sven</creatorcontrib><creatorcontrib>Schlageter, Vincent</creatorcontrib><creatorcontrib>Badertscher, Patrick</creatorcontrib><creatorcontrib>Krisai, Philipp</creatorcontrib><creatorcontrib>Jousset, Florian</creatorcontrib><creatorcontrib>Küffer, Thomas</creatorcontrib><creatorcontrib>Madaffari, Antonio</creatorcontrib><creatorcontrib>Schaer, Beat</creatorcontrib><creatorcontrib>Osswald, Stefan</creatorcontrib><creatorcontrib>Sticherling, Christian</creatorcontrib><creatorcontrib>Kühne, Michael</creatorcontrib><title>Atrial substrate characterization based on bipolar voltage electrograms acquired with multipolar, focal and mini-electrode catheters</title><title>Europace (London, England)</title><addtitle>Europace</addtitle><description>Abstract Background Bipolar voltage (BV) electrograms for left atrial (LA) substrate characterization depend on catheter design and electrode configuration. Aims The aim of the study was to investigate the relationship between the BV amplitude (BVA) using four catheters with different electrode design and to identify their specific LA cutoffs for scar and healthy tissue. Methods and results Consecutive high-resolution electroanatomic mapping was performed using a multipolar-minielectrode Orion catheter (Orion-map), a duo-decapolar circular mapping catheter (Lasso-map), and an irrigated focal ablation catheter with minielectrodes (Mifi-map). Virtual remapping using the Mifi-map was performed with a 4.5 mm tip-size electrode configuration (Nav-map). BVAs were compared in voxels of 3 × 3 × 3 mm3. The equivalent BVA cutoff for every catheter was calculated for established reference cutoff values of 0.1, 0.2, 0.5, 1.0, and 1.5 mV. We analyzed 25 patients (72% men, age 68 ± 15 years). For scar tissue, a 0.5 mV cutoff using the Nav corresponds to a lower cutoff of 0.35 mV for the Orion and of 0.48 mV for the Lasso. Accordingly, a 0.2 mV cutoff corresponds to a cutoff of 0.09 mV for the Orion and of 0.14 mV for the Lasso. For healthy tissue cutoff at 1.5 mV, a larger BVA cutoff for the small electrodes of the Orion and the Lasso was determined of 1.68 and 2.21 mV, respectively. Conclusion When measuring LA BVA, significant differences were seen between focal, multielectrode, and minielectrode catheters. Adapted cutoffs for scar and healthy tissue are required for different catheters. Graphical Abstract Graphical abstract Pipeline of the analysis leading to the individual cutoff for every catheter based on the reference catheter value: Color-coded consecutive voltage mapping using the Orion, Lasso, Mifi, and Nav catheter in 3D (x–y–z in mm) results after processing in the BVA cutoff values for an individual catheter type.</description><subject>Clinical Research</subject><issn>1099-5129</issn><issn>1532-2092</issn><issn>1532-2092</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>TOX</sourceid><recordid>eNqFkc1v1DAQxSMEoh9w54R8RIKAx14n8QlVFV9SJS5wtibOZNfIiVPb2ao984fjarcVnDh5JP_eex6_qnoF_D1wLT_QGsOClsqAA4j2SXUKSopacC2elplrXSsQ-qQ6S-kX57wVWj2vTmQLjWpaOK1-X-To0LO09ilHzMTsDiPaTNHdYXZhZj0mGtj94JbgMbJ98Bm3xMiTzTFsI06Job1eXSzgjcs7Nq0-H-h3bAy2BOA8sMnNrj6qhpKEeUclKL2ono3oE708nufVz8-fflx-ra--f_l2eXFV242UuR6h7Ts7NEojSoC-b0RrOzUMYsOl1orAghz5hm_GXgreEYnyJ0BYdgWrtDyvPh58l7WfaLA0l5W9WaKbMN6agM78ezO7ndmGvQEuRNfwpji8OTrEcL1SymZyyZL3OFNYkxEdCMWVAF5QfkBtDClFGh9zgJv79sxDe-bYXpG8_vt9j4KHugrw9gCEdfm_3R_MI6yF</recordid><startdate>20230519</startdate><enddate>20230519</enddate><creator>Knecht, Sven</creator><creator>Schlageter, Vincent</creator><creator>Badertscher, Patrick</creator><creator>Krisai, Philipp</creator><creator>Jousset, Florian</creator><creator>Küffer, Thomas</creator><creator>Madaffari, Antonio</creator><creator>Schaer, Beat</creator><creator>Osswald, Stefan</creator><creator>Sticherling, Christian</creator><creator>Kühne, Michael</creator><general>Oxford University Press</general><scope>TOX</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-0807-4827</orcidid><orcidid>https://orcid.org/0000-0001-9751-0557</orcidid><orcidid>https://orcid.org/0000-0001-8364-3279</orcidid><orcidid>https://orcid.org/0000-0001-7122-021X</orcidid><orcidid>https://orcid.org/0000-0003-1768-1968</orcidid><orcidid>https://orcid.org/0000-0002-4367-2363</orcidid><orcidid>https://orcid.org/0000-0001-8428-7050</orcidid><orcidid>https://orcid.org/0000-0003-3553-4945</orcidid><orcidid>https://orcid.org/0000-0001-6305-5103</orcidid><orcidid>https://orcid.org/0000-0002-2937-3711</orcidid><orcidid>https://orcid.org/0000-0002-9240-6731</orcidid></search><sort><creationdate>20230519</creationdate><title>Atrial substrate characterization based on bipolar voltage electrograms acquired with multipolar, focal and mini-electrode catheters</title><author>Knecht, Sven ; Schlageter, Vincent ; Badertscher, Patrick ; Krisai, Philipp ; Jousset, Florian ; Küffer, Thomas ; Madaffari, Antonio ; Schaer, Beat ; Osswald, Stefan ; Sticherling, Christian ; Kühne, Michael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c433t-f17b8cd659aa311bb627c85dd2403995e1c13f0404fb3208ee21271ea6561c593</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Clinical Research</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Knecht, Sven</creatorcontrib><creatorcontrib>Schlageter, Vincent</creatorcontrib><creatorcontrib>Badertscher, Patrick</creatorcontrib><creatorcontrib>Krisai, Philipp</creatorcontrib><creatorcontrib>Jousset, Florian</creatorcontrib><creatorcontrib>Küffer, Thomas</creatorcontrib><creatorcontrib>Madaffari, Antonio</creatorcontrib><creatorcontrib>Schaer, Beat</creatorcontrib><creatorcontrib>Osswald, Stefan</creatorcontrib><creatorcontrib>Sticherling, Christian</creatorcontrib><creatorcontrib>Kühne, Michael</creatorcontrib><collection>Oxford Journals Open Access Collection</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Europace (London, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Knecht, Sven</au><au>Schlageter, Vincent</au><au>Badertscher, Patrick</au><au>Krisai, Philipp</au><au>Jousset, Florian</au><au>Küffer, Thomas</au><au>Madaffari, Antonio</au><au>Schaer, Beat</au><au>Osswald, Stefan</au><au>Sticherling, Christian</au><au>Kühne, Michael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Atrial substrate characterization based on bipolar voltage electrograms acquired with multipolar, focal and mini-electrode catheters</atitle><jtitle>Europace (London, England)</jtitle><addtitle>Europace</addtitle><date>2023-05-19</date><risdate>2023</risdate><volume>25</volume><issue>5</issue><issn>1099-5129</issn><issn>1532-2092</issn><eissn>1532-2092</eissn><abstract>Abstract Background Bipolar voltage (BV) electrograms for left atrial (LA) substrate characterization depend on catheter design and electrode configuration. Aims The aim of the study was to investigate the relationship between the BV amplitude (BVA) using four catheters with different electrode design and to identify their specific LA cutoffs for scar and healthy tissue. Methods and results Consecutive high-resolution electroanatomic mapping was performed using a multipolar-minielectrode Orion catheter (Orion-map), a duo-decapolar circular mapping catheter (Lasso-map), and an irrigated focal ablation catheter with minielectrodes (Mifi-map). Virtual remapping using the Mifi-map was performed with a 4.5 mm tip-size electrode configuration (Nav-map). BVAs were compared in voxels of 3 × 3 × 3 mm3. The equivalent BVA cutoff for every catheter was calculated for established reference cutoff values of 0.1, 0.2, 0.5, 1.0, and 1.5 mV. We analyzed 25 patients (72% men, age 68 ± 15 years). For scar tissue, a 0.5 mV cutoff using the Nav corresponds to a lower cutoff of 0.35 mV for the Orion and of 0.48 mV for the Lasso. Accordingly, a 0.2 mV cutoff corresponds to a cutoff of 0.09 mV for the Orion and of 0.14 mV for the Lasso. For healthy tissue cutoff at 1.5 mV, a larger BVA cutoff for the small electrodes of the Orion and the Lasso was determined of 1.68 and 2.21 mV, respectively. Conclusion When measuring LA BVA, significant differences were seen between focal, multielectrode, and minielectrode catheters. Adapted cutoffs for scar and healthy tissue are required for different catheters. Graphical Abstract Graphical abstract Pipeline of the analysis leading to the individual cutoff for every catheter based on the reference catheter value: Color-coded consecutive voltage mapping using the Orion, Lasso, Mifi, and Nav catheter in 3D (x–y–z in mm) results after processing in the BVA cutoff values for an individual catheter type.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>37165671</pmid><doi>10.1093/europace/euad127</doi><orcidid>https://orcid.org/0000-0002-0807-4827</orcidid><orcidid>https://orcid.org/0000-0001-9751-0557</orcidid><orcidid>https://orcid.org/0000-0001-8364-3279</orcidid><orcidid>https://orcid.org/0000-0001-7122-021X</orcidid><orcidid>https://orcid.org/0000-0003-1768-1968</orcidid><orcidid>https://orcid.org/0000-0002-4367-2363</orcidid><orcidid>https://orcid.org/0000-0001-8428-7050</orcidid><orcidid>https://orcid.org/0000-0003-3553-4945</orcidid><orcidid>https://orcid.org/0000-0001-6305-5103</orcidid><orcidid>https://orcid.org/0000-0002-2937-3711</orcidid><orcidid>https://orcid.org/0000-0002-9240-6731</orcidid><oa>free_for_read</oa></addata></record>
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title	Atrial substrate characterization based on bipolar voltage electrograms acquired with multipolar, focal and mini-electrode catheters
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