Optimal electrogram voltage recording technique for detecting the acute ablative tissue injury in the human right atrium

Yenn Jiang Lin, Ching Tai Tai, Li Wei Lo, Ameya R. Udyavar, Shih Lin Chang, Wanwarang Wongcharoen, Ta Chuan Tuan, Yu Feng Hu, Shuo Ju Chiang, Yi Jen Chen, Shih Ann Chen

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: The optimal recording technique of the electrogram voltage for detecting abnormal atrial tissue remains unclear. The aim of this study was to compare the impact of various recording techniques on the electrogram voltage after the delivery of ablation therapy in the human right atrium (RA). Material and Methods: Noncontact mapping was performed in 27 patients with typical atrial flutter (mean age = 63 ± 16, males = 20). Noncontact unipolar and bipolar electrograms were obtained before and after cavotricuspid isthmus (CTI) linear ablation. All unipolar electrograms were acquired with both wide-band filtering (0.5-300 Hz) and narrow-band filtering (32-300 Hz). The unipolar voltage measurements included both the peak-to-peak voltage and peak-negative voltage (PNV) for both filter settings. Results: A comparison of the electrogram voltage along the ablation line before and after the ablation demonstrated a greater reduction in the unipolar PNV with wide-band filtering (70 ± 24%) than in any of the other recording modalities (P = 0.03). It was the most sensitive and specific recording technique to predict conduction block (cut-off Value 0.35 mV; sensitivity = 94.4% and specificity = 80%). A comparison of the electrogram voltage between the ablated atrial myocardium and nearby nonablated myocardium showed that the unipolar PNV with the wide-band filtering remained the most sensitive method to detect the acute ablative tissue injury, whereas the peak-to-peak bipolar voltage was the most specific method. Conclusion: The noncontact unipolar electrogram using the PNV with wide-band filter settings (0.5-300 Hz) provided the most sensitive recording technique for detecting acute ablative tissue injury.

Original languageEnglish
Pages (from-to)617-622
Number of pages6
JournalJournal of Cardiovascular Electrophysiology
Volume18
Issue number6
DOIs
Publication statusPublished - Jun 2007
Externally publishedYes

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Heart Atria
Myocardium
Wounds and Injuries
Atrial Flutter
Sensitivity and Specificity
Therapeutics

Keywords

  • Ablation
  • Atrial flutter
  • Myocardium
  • Voltage

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology

Cite this

Optimal electrogram voltage recording technique for detecting the acute ablative tissue injury in the human right atrium. / Lin, Yenn Jiang; Tai, Ching Tai; Lo, Li Wei; Udyavar, Ameya R.; Chang, Shih Lin; Wongcharoen, Wanwarang; Tuan, Ta Chuan; Hu, Yu Feng; Chiang, Shuo Ju; Chen, Yi Jen; Chen, Shih Ann.

In: Journal of Cardiovascular Electrophysiology, Vol. 18, No. 6, 06.2007, p. 617-622.

Research output: Contribution to journalArticle

Lin, Yenn Jiang ; Tai, Ching Tai ; Lo, Li Wei ; Udyavar, Ameya R. ; Chang, Shih Lin ; Wongcharoen, Wanwarang ; Tuan, Ta Chuan ; Hu, Yu Feng ; Chiang, Shuo Ju ; Chen, Yi Jen ; Chen, Shih Ann. / Optimal electrogram voltage recording technique for detecting the acute ablative tissue injury in the human right atrium. In: Journal of Cardiovascular Electrophysiology. 2007 ; Vol. 18, No. 6. pp. 617-622.
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abstract = "Background: The optimal recording technique of the electrogram voltage for detecting abnormal atrial tissue remains unclear. The aim of this study was to compare the impact of various recording techniques on the electrogram voltage after the delivery of ablation therapy in the human right atrium (RA). Material and Methods: Noncontact mapping was performed in 27 patients with typical atrial flutter (mean age = 63 ± 16, males = 20). Noncontact unipolar and bipolar electrograms were obtained before and after cavotricuspid isthmus (CTI) linear ablation. All unipolar electrograms were acquired with both wide-band filtering (0.5-300 Hz) and narrow-band filtering (32-300 Hz). The unipolar voltage measurements included both the peak-to-peak voltage and peak-negative voltage (PNV) for both filter settings. Results: A comparison of the electrogram voltage along the ablation line before and after the ablation demonstrated a greater reduction in the unipolar PNV with wide-band filtering (70 ± 24{\%}) than in any of the other recording modalities (P = 0.03). It was the most sensitive and specific recording technique to predict conduction block (cut-off Value 0.35 mV; sensitivity = 94.4{\%} and specificity = 80{\%}). A comparison of the electrogram voltage between the ablated atrial myocardium and nearby nonablated myocardium showed that the unipolar PNV with the wide-band filtering remained the most sensitive method to detect the acute ablative tissue injury, whereas the peak-to-peak bipolar voltage was the most specific method. Conclusion: The noncontact unipolar electrogram using the PNV with wide-band filter settings (0.5-300 Hz) provided the most sensitive recording technique for detecting acute ablative tissue injury.",
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T1 - Optimal electrogram voltage recording technique for detecting the acute ablative tissue injury in the human right atrium

AU - Lin, Yenn Jiang

AU - Tai, Ching Tai

AU - Lo, Li Wei

AU - Udyavar, Ameya R.

AU - Chang, Shih Lin

AU - Wongcharoen, Wanwarang

AU - Tuan, Ta Chuan

AU - Hu, Yu Feng

AU - Chiang, Shuo Ju

AU - Chen, Yi Jen

AU - Chen, Shih Ann

PY - 2007/6

Y1 - 2007/6

N2 - Background: The optimal recording technique of the electrogram voltage for detecting abnormal atrial tissue remains unclear. The aim of this study was to compare the impact of various recording techniques on the electrogram voltage after the delivery of ablation therapy in the human right atrium (RA). Material and Methods: Noncontact mapping was performed in 27 patients with typical atrial flutter (mean age = 63 ± 16, males = 20). Noncontact unipolar and bipolar electrograms were obtained before and after cavotricuspid isthmus (CTI) linear ablation. All unipolar electrograms were acquired with both wide-band filtering (0.5-300 Hz) and narrow-band filtering (32-300 Hz). The unipolar voltage measurements included both the peak-to-peak voltage and peak-negative voltage (PNV) for both filter settings. Results: A comparison of the electrogram voltage along the ablation line before and after the ablation demonstrated a greater reduction in the unipolar PNV with wide-band filtering (70 ± 24%) than in any of the other recording modalities (P = 0.03). It was the most sensitive and specific recording technique to predict conduction block (cut-off Value 0.35 mV; sensitivity = 94.4% and specificity = 80%). A comparison of the electrogram voltage between the ablated atrial myocardium and nearby nonablated myocardium showed that the unipolar PNV with the wide-band filtering remained the most sensitive method to detect the acute ablative tissue injury, whereas the peak-to-peak bipolar voltage was the most specific method. Conclusion: The noncontact unipolar electrogram using the PNV with wide-band filter settings (0.5-300 Hz) provided the most sensitive recording technique for detecting acute ablative tissue injury.

AB - Background: The optimal recording technique of the electrogram voltage for detecting abnormal atrial tissue remains unclear. The aim of this study was to compare the impact of various recording techniques on the electrogram voltage after the delivery of ablation therapy in the human right atrium (RA). Material and Methods: Noncontact mapping was performed in 27 patients with typical atrial flutter (mean age = 63 ± 16, males = 20). Noncontact unipolar and bipolar electrograms were obtained before and after cavotricuspid isthmus (CTI) linear ablation. All unipolar electrograms were acquired with both wide-band filtering (0.5-300 Hz) and narrow-band filtering (32-300 Hz). The unipolar voltage measurements included both the peak-to-peak voltage and peak-negative voltage (PNV) for both filter settings. Results: A comparison of the electrogram voltage along the ablation line before and after the ablation demonstrated a greater reduction in the unipolar PNV with wide-band filtering (70 ± 24%) than in any of the other recording modalities (P = 0.03). It was the most sensitive and specific recording technique to predict conduction block (cut-off Value 0.35 mV; sensitivity = 94.4% and specificity = 80%). A comparison of the electrogram voltage between the ablated atrial myocardium and nearby nonablated myocardium showed that the unipolar PNV with the wide-band filtering remained the most sensitive method to detect the acute ablative tissue injury, whereas the peak-to-peak bipolar voltage was the most specific method. Conclusion: The noncontact unipolar electrogram using the PNV with wide-band filter settings (0.5-300 Hz) provided the most sensitive recording technique for detecting acute ablative tissue injury.

KW - Ablation

KW - Atrial flutter

KW - Myocardium

KW - Voltage

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