Characterization of Propagation Patterns with Omnipolar EGM in Epicardial Multi-Electrode Arrays

Omnipolar Electrogram (OP-EGM) is a recently proposed technique to characterize myocardial propagation in multi-electrode catheters regardless of the angle between propagation direction and catheter bipolar. This work aims to evaluate the accuracy of atrial propagation parameters obtained with OP-EGM in sinus rhythm (SR) and in different patterns of atrial fibrillation (AF).Real and simulated unipolar electrograms (u-EGMs) were used in this study. For both types of data, conduction velocity was obtained for each clique of 4 neighbour electrodes using OP-EGM. As a reference, conduction velocity was also computed from local activation times (LATs) using a linear propagation model.Analysis of simulated data showed that conduction velocity had good concordance with propagation patterns for both estimations, although the LAT-based errors were lower in most of the cases. When conduction velocity magnitude (CV) was 1 mm/ms, its estimation errors (expressed as mean ± std) calculated with OP-EGM and from LATs were 0.053 ± 0.005 mm/ms and 0.003 ±2.1 ×10-5 mm/ms, respectively, when focus was at 30 mm from the bottom of the tissue slice, while propagation direction angular errors were 6.64 ± 4.3°and 4.35 ± 2.8°. In real data, maps obtained with OP-EGM presented smoother and more coherent patterns than those based on LATs.

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