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Testing a Simple Model of the Unipolar Electrogram in the Intact Human Heart and Examples of Applications

Orini, M; Taggart, P; Lambiase, PD; (2018) Testing a Simple Model of the Unipolar Electrogram in the Intact Human Heart and Examples of Applications. In: Computing in Cardiology 2018. IEEE: Maastricht, The Netherlands.. Green open access

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Abstract

The unipolar electrogram (UEG) is widely used in electrophysiological research and in the cathlab. We aimed to test a previously proposed simple model of the UEG against in-vivo human data and to use the model to investigate: (A) Accuracy of repolarization measurements; (B) Factors affecting UEG substrate mapping and (C) Interactions between APD and UEG T-wave alternans. UEGs were recorded in 10 patients using a multi-electrode sock. Local action potentials showing same activation and repolarization sequence as measured in-vivo were generated using analytical functions. Local UEGs were simulated as the difference between the local action potential and a position-independent component representing remote activity. Morphological correlation between recorded and simulated UEG was cc = 0.92 (0.79 − 0.97) (median Q1- Q3, N = 1, 756). Simulation studies showed: (A) Caution should be used when analyzing biphasic T-waves and Twaves associated with either very early or late repolarization. (B) Substrate mapping using UEG amplitude depends on the activation sequence and its total duration. (C) UEG TWA is not a specific surrogate for local APD alternans as it can be observed in sites without APD alternans due to variations in the remote component. In conclusion, the simple model provides a framework to improve the understanding and clinical utility of the UEG.

Type: Proceedings paper
Title: Testing a Simple Model of the Unipolar Electrogram in the Intact Human Heart and Examples of Applications
Event: Computing in Cardiology 2018
Location: Maastricht, Netherlands
Dates: September 23-26, 2018
ISBN-13: 9781728109589
Open access status: An open access version is available from UCL Discovery
DOI: 10.22489/CinC.2018.383
Publisher version: https://doi.org/10.22489/CinC.2018.383
Language: English
Additional information: This is an open-access publication, in which copyright in each article is held by its authors, who grant permission to copy and redistribute their work with attribution, under the terms of the Creative Commons Attribution License https://creativecommons.org/licenses/by/2.5/
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Clinical Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
URI: https://discovery.ucl.ac.uk/id/eprint/10079578
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