Unipolar atrial electrogram morphology from an epicardial and endocardial perspective

Heart Rhythm : the Official Journal of the Heart Rhythm Society
Lisette J M E van der DoesNatasja M S de Groot

Abstract

Endo-epicardial asynchrony (EEA) and the interplay between the endocardial and epicardial layers could be important in the pathophysiology of atrial arrhythmias. The morphologic differences between epicardial and endocardial atrial electrograms have not yet been described, and electrogram morphology may hold information about the presence of EEA. The purpose of this study was to directly compare epicardial to endocardial unipolar electrogram morphology during sinus rhythm (SR) and to evaluate whether EEA contributes to electrogram fractionation by correlating fractionation to spatial activation patterns. In 26 patients undergoing cardiac surgery, unipolar electrograms were simultaneously recorded from the epicardium and endocardium at the inferior, middle, and superior right atrial (RA) free wall during SR. Potentials were analyzed for epi-endocardial differences in local activation time, voltage, RS ratio, and fractionation. The surrounding and opposite electrograms of fractionated deflections were evaluated for corresponding local activation times in order to determine whether fractionation originated from EEA. The superior RA was predisposed to delayed activation, EEA, and fractionation. Both epicardial and endocardial elect...Continue Reading

Citations

Jun 7, 2018·Expert Review of Cardiovascular Therapy·Rohit K KharbandaNatasja M S De Groot
Aug 14, 2019·Pacing and Clinical Electrophysiology : PACE·Natasja M S de Groot, Maurits A Allessie
Oct 15, 2019·Pacing and Clinical Electrophysiology : PACE·Jacques Mt de Bakker
Feb 23, 2020·Journal of Clinical Medicine·Lisette J M E van der DoesNatasja M S de Groot
Feb 15, 2020·Journal of Cardiovascular Electrophysiology·Paul KnopsNatasja de Groot
Aug 19, 2020·Journal of the American Heart Association·Rohit K KharbandaNatasja M S de Groot
Jul 10, 2018·Interactive Cardiovascular and Thoracic Surgery·Lisette J M E van der DoesNatasja M S de Groot
May 16, 2020·Journal of Cardiovascular Translational Research·Roeliene StarreveldNatasja M S de Groot
Oct 10, 2020·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Mathijs S van SchieNatasja M S de Groot
Jan 12, 2021·European Heart Journal. Case Reports·Rohit K KharbandaNatasja M S de Groot
Jan 13, 2021·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Mathijs S van SchieNatasja M S de Groot
Mar 31, 2021·Journal of Cardiovascular Translational Research·Lisette J M E van der DoesNatasja M S de Groot
Apr 1, 2021·HeartRhythm Case Reports·Lianne N van StaverenNatasja M S de Groot
Apr 13, 2021·Frontiers in Physiology·Ziliang YeNatasja M S de Groot

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