Mini-, Micro-, and Conventional Electrodes: An in Vivo Electrophysiology and Ex Vivo Histology Head-to-Head Comparison

Claire A Glashan; Hans K C Beukers; Bawer J Tofig; Qian Tao; Sira Blom; Bart Mertens; Steen B Kristiansen; Katja Zeppenfeld

doi:10.1016/j.jacep.2020.08.014

Mini-, Micro-, and Conventional Electrodes: An in Vivo Electrophysiology and Ex Vivo Histology Head-to-Head Comparison

JACC Clin Electrophysiol. 2021 Feb;7(2):197-205. doi: 10.1016/j.jacep.2020.08.014. Epub 2020 Oct 28.

Authors

Claire A Glashan¹, Hans K C Beukers¹, Bawer J Tofig², Qian Tao³, Sira Blom¹, Bart Mertens⁴, Steen B Kristiansen², Katja Zeppenfeld⁵

Affiliations

¹ Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands.
² Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.
³ Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
⁴ Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands.
⁵ Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands. Electronic address: k.zeppenfeld@lumc.nl.

PMID: 33602400
DOI: 10.1016/j.jacep.2020.08.014

Abstract

Objectives: This study sought to assess the relative effect of catheter, tissue, and catheter-tissue parameters, on the ability to determine the amount of viable myocardium in vivo.

Background: Although multiple variables impact bipolar voltages (BVs), electrode size, interelectrode spacing, and directional dependency are of particular interest with the development of catheters incorporating mini and microelectrodes.

Methods: Nine swine with early reperfusion myocardial infarctions were mapped using the QDot catheter and then remapped using a Pentaray catheter. All QDot points were matched with Pentaray points within 5 mm. The swine were sacrificed, and mapping data projected onto the heart. Transmural biopsies corresponding to mapping points were obtained, allowing a comparison of electrograms recorded by mini, micro-, and conventional electrodes with histology.

Results: The conventional BV of 2,322 QDot points was 1.9 ± 1.3 mV. The largest of the 3 microelectrode BVs (BV_µMax) average 4.8 ± 3.1 mV. The difference between the largest (BV_μMax) and smallest (BV_μMin) at a given location was 53.7 ± 18.1%. The relationships between both BV_μMax and BV_μMin and between the conventional BV and BV_μMax were positively related but with a significant spread in data, which was more pronounced for the latter. Pentaray points positively related to the BV_μMax with poor fit. On histology, increasing viable myocardium increased voltage, but both the slope coefficient and fit were best for BV_μMax.

Conclusions: Using histology, we could demonstrate that BV_μMax is superior to identify viable myocardium compared with BV_C and BV using the Pentaray catheter. The ability to simultaneously record 3 BV_μs with different orientations, for the same beat, with controllable contact and selecting BV_μMax for local BV may partially compensate for wave front direction.

Keywords: electrode size; electrode spacing; histology; microelectrodes; mini electrodes; swine; voltage mapping.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Animals
Cardiac Electrophysiology
Electrophysiologic Techniques, Cardiac*
Heart*
Microelectrodes
Myocardium
Swine