Usefulness of filtered unipolar electrogram morphology for evaluating transmurality of ablated lesions during pulmonary vein isolation

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• 作者：Rikitake Kogawa ; MD ; Ichiro Watanabe ; MD ; ^{watanabe.ichirou@nihon-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Yasuo Okumura ; MD ; Hiroaki Mano ; MD ; Kazumasa Sonoda ; MD ; Koichi Nagashima ; MD ; Naoko Sasaki ; MD ; Kimie Ohkubo ; MD ; Keiko Takahashi ; MD ; Kazuki Iso ; MD ; Sayaka Kurokawa ; MD ; Toshiko Nakai ; MD ; Atsushi Hirayama ; MD
• 关键词：Atrial fibrillation ; Pulmonary vein isolation ; Filtered unipolar electrogram ; Durable pulmonary vein isolation
• 刊名：Journal of Arrhythmia
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：32
• 期：2
• 页码：108-111
• 全文大小：1577 K

文摘

Although alteration of the amplitude and morphology of bipolar electrograms is used widely as a guide of the ablation effect, there is little information concerning unipolar electrograms. The amplitude and morphology of filtered bipolar (BP) and filtered unipolar (UP) electrograms were compared during pulmonary vein isolation in patients with atrial fibrillation.

Methods

BP (30–250 Hz) and UP (30–100 Hz) signals from the ablation catheter were recorded before and after each ablation point at the pulmonary vein antrum in 6 patients with atrial fibrillation.

Results

In the electrogram group with low-voltage amplitude in BP electrograms before ablation (<0.5 mV), the reduction in amplitude after ablation was significantly greater in the UP than in the BP electrograms, whereas the reduction was similar between the two recording methods in the electrogram group with high-voltage amplitude in BP electrograms (≥0.5 mV). Furthermore, the S wave in the UP electrograms disappeared at the sites of no pace capture after ablation, whereas no characteristic morphologic changes were observed in the BP electrograms.

Conclusion

Filtered UP electrograms may be useful in assessing the effectiveness of lesion formation.