Implantable Defibrillator Electrograms and Origin of Left Ventricular Impulses: An Analysis of Regionalization Ability and Visual Spatial Resolution

ICD Electrograms and Origin of Impulses. Introduction: The implantable cardioverter‐defibrillator (ICD) electrogram (EG) is a documentation of ventricular tachycardia. We prospectively analyzed EGs from ICD electrodes located at the right ventricle apex to establish (1) ability to regionalize origin...

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Published in:Journal of cardiovascular electrophysiology 2012-05, Vol.23 (5), p.506-514
Main Authors: ALMENDRAL, JESÚS, ATIENZA, FELIPE, EVERSS, ESTRELLA, CASTILLA, LORETO, GONZALEZ-TORRECILLA, ESTEBAN, ORMAETXE, JOSÉ, ARENAL, ANGEL, ORTIZ, MERCEDES, SANROMÁN-JUNQUERA, MARGARITA, MORA-JIMÉNEZ, INMACULADA, BELLON, JOSÉ M., ROJO, JOSÉ L.
Format: Article
Language:English
Subjects:
Cardiac Pacing, Artificial
Cardiovascular diseases
catheter ablation
Defibrillators
Defibrillators, Implantable
Discriminant Analysis
Electric Countershock - instrumentation
electroanatomical mapping
Electrodes
electrogram
Electrophysiologic Techniques, Cardiac
Electrophysiology
Equipment Design
Female
Heart
Heart Ventricles - physiopathology
Humans
implantable defibrillator
Logistic Models
Male
Middle Aged
pace-mapping
Predictive Value of Tests
Prospective Studies
Signal Processing, Computer-Assisted
Site location
Spain
spatial discrimination
Tachycardia
Tachycardia, Ventricular - diagnosis
Tachycardia, Ventricular - physiopathology
Tachycardia, Ventricular - therapy
Ventricle
Ventricular Function, Left
ventricular tachycardia
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Summary:ICD Electrograms and Origin of Impulses. Introduction: The implantable cardioverter‐defibrillator (ICD) electrogram (EG) is a documentation of ventricular tachycardia. We prospectively analyzed EGs from ICD electrodes located at the right ventricle apex to establish (1) ability to regionalize origin of left ventricle (LV) impulses, and (2) spatial resolution to distinguish between paced sites. Methods and Results: LV electro‐anatomic maps were generated in 15 patients. ICD‐EGs were recorded during pacing from 22 ± 10 LV sites. Voltage of far‐field EG deflections (initial, peak, final) and time intervals between far‐field and bipolar EGs were measured. Blinded visual analysis was used for spatial resolution. Initial deflections were more negative and initial/peak ratios were larger for lateral versus septal and superior versus inferior sites. Time intervals were shorter for apical versus basal and septal versus lateral sites. Best predictive cutoff values were voltage of initial deflection 0.45 for a lateral site, voltage of final deflection
ISSN:1045-3873
1540-8167
DOI:10.1111/j.1540-8167.2011.02233.x