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Journal of Interventional Cardiac Electrophysiology

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Open Access 01-11-2011

Utility of virtual unipolar electrogram morphologies to detect transverse conduction block and turnaround points of typical atrial flutter

Authors: Mitsuru Takami, Akihiro Yoshida, Koji Fukuzawa, Asumi Takei, Gaku Kanda, Kaoru Takami, Hiroyuki Kumagai, Satoko Tanaka, Mitsuaki Itoh, Kimitake Imamura, Ryudo Fujiwara, Atsushi Suzuki, Ken-ichi Hirata

Published in: Journal of Interventional Cardiac Electrophysiology | Issue 2/2011

Abstract

Background

Noncontact mapping is useful for the diagnosis of various arrhythmias. Virtual unipolar electrogram morphologies (VUEM) of the conduction block and the turnaround points, however, are not well defined. We compared the VUEM characteristics of a transverse conduction block in the posterior right atrium (RA) with those of contact bipolar electrograms obtained during typical atrial flutter (AFL).

Methods

Contact bipolar electrograms were used to map the posterior RA during typical AFL in 16 patients. Twenty points of the VUEM recorded along the block line were analyzed and compared with contact bipolar electrograms.

Results

Seventeen AFLs were analyzed. Fifteen AFLs showed an incomplete transverse conduction block in the posterior RA by contact bipolar mapping. A double potential on the block line corresponded to the two components of the VUEM, in which the second component showed an Rs, RS, or rS pattern. At the turnaround point, a fused double potential of the contact bipolar electrograms corresponded to a change of the second component of the VUEM from an rS to a QS morphology. Two AFLs showed a complete block line in the posterior RA. The contact bipolar electrogram showed double potentials from the inferior vena cava to the superior vena cava, whereas the second component of the VUEM remained in an unchanged Rs, RS, or rS pattern.

Conclusion

VUEM analysis was a reliable method for identifying the posterior block line during AFL. This method may also be applicable for detecting block lines and turnaround points of circuits in other unmappable arrhythmias.

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Title: Utility of virtual unipolar electrogram morphologies to detect transverse conduction block and turnaround points of typical atrial flutter
Authors: Mitsuru Takami
Akihiro Yoshida
Koji Fukuzawa
Asumi Takei
Gaku Kanda
Kaoru Takami
Hiroyuki Kumagai
Satoko Tanaka
Mitsuaki Itoh
Kimitake Imamura
Ryudo Fujiwara
Atsushi Suzuki
Ken-ichi Hirata
Publication date: 01-11-2011
Publisher: Springer US
Published in: Journal of Interventional Cardiac Electrophysiology / Issue 2/2011
Print ISSN: 1383-875X
Electronic ISSN: 1572-8595
DOI: https://doi.org/10.1007/s10840-011-9571-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Utility of virtual unipolar electrogram morphologies to detect transverse conduction block and turnaround points of typical atrial flutter

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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