Improved Activation Time Assignment of Unipolar Electrograms from Ischemic Canine Epicardium.

Aims: The present study attempts to develop an objective, statistically based set of criteria for activation time determination from unipolar electrograms (U-EGMs) using a standard of activation related to biophysical theory. Methods: A high-resolution assembly of U-EGMs obtained from the epicardial...

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Publicado en:Pacing & Clinical Electrophysiology Vol. 34; no. 9; pp. 1105 - 1116
Autores principales: Caref, Edward B., Ndrepepa, Gjin, Turitto, Gioia, Restivo, Mark, El-Sherif, Nabil
Formato: equations & formulas pictorial research tables/charts tracings Journal Article
Publicado: Wiley-Blackwell Sep2011
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2011
      vid: 34
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        10.1111/j.1540-8159.2011.03116.x
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        atl: Improved Activation Time Assignment of Unipolar Electrograms from Ischemic Canine Epicardium.
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          Caref, Edward B.
          Ndrepepa, Gjin
          Turitto, Gioia
          Restivo, Mark
          El-Sherif, Nabil
        affil: State University of New York Health Science Center at Brooklyn and NY Harbor VA Healthcare System, Brooklyn, New York
      sug:
        subj:
          Biophysiological Methods
          Electrophysiology Standards
          Time Factors
          Myocardial Ischemia Physiopathology
          Pericardium Physiopathology
          Body Surface Potential Mapping Methods
          Animal Studies
          Dogs
          Algorithms
          Electric Stimulation
          Data Analysis Software
          Descriptive Statistics
          Linear Regression
          Funding Source
      ab: Aims: The present study attempts to develop an objective, statistically based set of criteria for activation time determination from unipolar electrograms (U-EGMs) using a standard of activation related to biophysical theory. Methods: A high-resolution assembly of U-EGMs obtained from the epicardial surface of the canine postinfarction heart were analyzed in order to achieve the best prediction of local versus distant activation. An activation time standard (ATS) consisted of three properties: (1) propagation of activation, evidenced by a linear temporal shift of waveforms from closely spaced U-EGMs with little or no decay in amplitude; (2) cycle length-dependent changes of those propagating waveforms; and (3) evidence of electrotonic deflections, seen as nonpropagating potentials having decaying amplitude with distance. Results: A number of U-EGM features were calculated and subjected to analysis by comparing their occurrence with the ATS. A discriminant function analysis incorporating multiple features (Voltage, −dV/dt and Ratio) of major U-EGM deflections improved prediction of activation time of complex fractionated EMGs from ischemic canine epicardium to 90%. Conclusion: A unique discriminant function based on sound biophysical principles markedly improved prediction of activation time of complex U-EGMs from ischemic canine epicardium. A computerized version of the algorithm could be developed to provide more accurate activation maps for both basic and clinical use. (PACE 2011; 34:1105-1115)
      pubtype: Academic Journal
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        equations & formulas
        pictorial
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      ougenre: Article
    language: English
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