3D Omnipolar Technology for the Assessment of the Intramural Electrical Activity

Elisa Ramirez1, Johanna Tonko2, Mark Trew3, Raul Alos4, Jose Millet5, Francisco Castells6
1Institute ITACA, Universitat Politecnica de Valencia, 2Imperial College of London, 3The University of Auckland, 4Universitat Politecnica de Valencia, 5BioITACA-UPV, 6Universitat Politècnica de Valencia


Abstract

Omnipolar Technology (OT) are claimed to provide orientation-independent estimations of bipolar electrical activations and are increasingly used for substrate characterization of the heart. Current formulations rely on a two-dimensional approach, which overcomes the limitations of bipolar electrograms (EGMs) in capturing wavefront activations arriving from perpendicular directions. This work extends this concept and proposes a novel 3D omnipolar framework, in order to account for a tridimensional propagation model within the cardiac tissue. The 3D OT approach is defined from a 3D clique that comprises three orthogonal bipolar signals that, in turn, depict a 3D electrical field loop. For the assessment and validation of this framework, we employed mathematical simulations involving parametric representations of wavefront propagation by varying direction, curvature and conduction velocity. The proposed 3D OT consistently outperformed the 2D approach across all conditions, particularly in wavefronts with significant elevation angle. Moreover, this model was tested on recordings from plunge needle electrodes in in-vivo animal experiments of ovine model. Results confirm that the 3D framework better captures the transmural propagation offering new insights and possibilities for the estimation of intramural mapping.