Skip to main content
SpringerLink
Log in

Extracellular Mapping of Arrhythmias

  • Chapter
  • First Online:
Cardiac Bioelectric Therapy

  • 661 Accesses

Abstract

For over a hundred years, investigators have recorded electrograms from the heart and used these to determine the sequence of activation of the heart in normal rhythms and arrhythmias. With more complex analysis techniques, other parameters such as potential amplitudes, recovery times, dominant frequency, propagation velocity, and phase can be derived. This chapter reviews the underlying assumptions and electrophysiological principals used to construct, display, and interpret the spatial and temporal representation of these data. Today, these techniques are used for research, clinical diagnosis and treatment. Understanding the strengths and limitations of these techniques are essential to understanding mechanisms and treatment.

This work was supported by the National Institutes of Health R01-HL032257.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Janse MJ. Some historical notes on the mapping of arrhythmias. In: Shenasa M, Borggrefe M, Breithardt G, editors. Cardiac mapping. Mount Kisco: Futura Publishing Company, Inc; 1993. p. 3–10.

    Google Scholar 

  2. Lewis TFS, Stroud WD. Observation upon flutter and fibrillation I. Heart. 1918;7:127–30.

    Google Scholar 

  3. Durrer D, van Dam RT, Freud GE, Janse MJ, Meijler FL, Arzbaecher RC. Total excitation of the isolated human heart. Circulation. 1970;41(6):899–912.

    Article  CAS  PubMed  Google Scholar 

  4. Spach MS, Miller WT 3rd, Miller-Jones E, Warren RB, Barr RC. Extracellular potentials related to intracellular action potentials during impulse conduction in anisotropic canine cardiac muscle. Circ Res. 1979;45(2):188–204.

    Article  CAS  PubMed  Google Scholar 

  5. Kootsey JM, Johnson EA. The origin of the electrocardiogram: relationship between transmembrane potential and electrocardiogram. In: Nelson CV, Geselowitz DB, editors. The theoretical basis of electrocardiology. Oxford, UK: Clarendon Press; 1976. p. 21–43.

    Google Scholar 

  6. Ideker RE, Smith WM, Blanchard SM, Reiser SL, Simpson EV, Wolf PD, et al. The assumptions of isochronal cardiac mapping. Pacing Clin Electrophysiol. 1989;12(3):456–78.

    Article  CAS  PubMed  Google Scholar 

  7. Biermann MS, Borggrefe M, Hindricks M, Haverkamp G, Breithardt WG. The interpretation of cardiac electrograms. In: Shenasa M, Borggrefe M, Breithardt G, editors. Cardiac mapping. 1st ed. Mount Kisco: Futura Publishing Company, Inc.; 1993. p. 11–34.

    Google Scholar 

  8. Schuessler RB, Kawamoto T, Hand DE, Mitsuno M, Bromberg BI, Cox JL, et al. Simultaneous epicardial and endocardial activation sequence mapping in the isolated canine right atrium. Circulation. 1993;88(1):250–63.

    Article  CAS  PubMed  Google Scholar 

  9. Kay MW, Bayly PV, Schuessler RB. Effects of measurement error and sampling resolution on estimates of atrial tissue recovery parameters. Ann Biomed Eng. 2000;28(6):677–90.

    Article  CAS  PubMed  Google Scholar 

  10. Cobb FR, Blumenschein SD, Sealy WC, Boineau JP, Wagner GS, Wallace AG. Successful surgical interruption of the bundle of Kent in a patient with Wolff-Parkinson-White syndrome. Circulation. 1968;38(6):1018–29.

    Article  CAS  PubMed  Google Scholar 

  11. van der Does L, Kik C, Allessie M, de Groot N. Endo-epicardial dissociation in conduction. Eur Heart J. 2017;38(22):1775.

    PubMed  Google Scholar 

  12. de Groot NM, Houben RP, Smeets JL, Boersma E, Schotten U, Schalij MJ, et al. Electropathological substrate of longstanding persistent atrial fibrillation in patients with structural heart disease: epicardial breakthrough. Circulation. 2010;122(17):1674–82.

    Article  PubMed  Google Scholar 

  13. Yaksh A, van der Does LJ, Kik C, Knops P, Oei FB, van de Woestijne PC, et al. A novel intra-operative, high-resolution atrial mapping approach. J Interv Card Electrophysiol. 2015;44(3):221–5.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Witkowski FX, Penkoske MD, Kavanagh KM. Mapping of ventricular fibrillation: technical considerations. 1st ed. Mount Kisco: Futura Publishing Company, Inc.; 1993.

    Google Scholar 

  15. Xu L, Gutbrod SR, Ma Y, Petrossians A, Liu Y, Webb RC, et al. Materials and fractal designs for 3D multifunctional integumentary membranes with capabilities in cardiac electrotherapy. Adv Mater. 2015;27(10):1731–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Gutbrod SR, Sulkin MS, Rogers JA, Efimov IR. Patient-specific flexible and stretchable devices for cardiac diagnostics and therapy. Prog Biophys Mol Biol. 2014;115(2-3):244–51.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Barr RC, Spach MS. Sampling rates required for digital recording of intracellular and extracellular cardiac potentials. Circulation. 1977;55(1):40–8.

    Article  CAS  PubMed  Google Scholar 

  18. Vijayakumar R, Vasireddi SK, Cuculich PS, Faddis MN, Rudy Y. Methodology considerations in phase mapping of human cardiac arrhythmias. Circ Arrhythm Electrophysiol. 2016;9(11):e004409.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Duchateau J, Potse M, Dubois R. Spatially coherent activation maps for electrocardiographic imaging. IEEE Trans Biomed Eng. 2017;64(5):1149–56.

    Article  PubMed  Google Scholar 

  20. Rodefeld MD, Branham BH, Schuessler RB, Hand DE, Gamache CM, Platt JW, et al. Global electrophysiological mapping of the atrium: computerized three-dimensional mapping system. Pacing Clin Electrophysiol. 1997;20(9 Pt 1):2227–36.

    Article  CAS  PubMed  Google Scholar 

  21. Branham BH, Cox JL, Boineau JP, Schuessler RB, inventor; Washington Univeristy Research Office, assignee. computerized three-dimensional crdiac mapping with interactive visual displays. US patent US5687737A, 1994.

    Google Scholar 

  22. Spragg DD, Khurram I, Zimmerman SL, Yarmohammadi H, Barcelon B, Needleman M, et al. Initial experience with magnetic resonance imaging of atrial scar and co-registration with electroanatomic voltage mapping during atrial fibrillation: success and limitations. Heart Rhythm. 2012;9(12):2003–9.

    Article  PubMed  Google Scholar 

  23. Schuessler RB, Grayson TM, Bromberg BI, Cox JL, Boineau JP. Cholinergically mediated tachyarrhythmias induced by a single extrastimulus in the isolated canine right atrium. Circ Res. 1992;71(5):1254–67.

    Article  CAS  PubMed  Google Scholar 

  24. van Hunnik A. Dynamics of porpagation pattern and anti-arrhythmic mechanisms during atrial fibrillation. In: Dynamics of propagation patterns and anti-arrhythmic mechanisms during atrial fibrillation. Dissertation. Maastricht: Univeristy of Masstricht; 2018.

    Google Scholar 

  25. Rogers JM, Bayly PV, Ideker RE, Smith WM. Quantitative techniques for analyzing high-resolution cardiac-mapping data. IEEE Eng Med Biol Mag. 1998;17(1):62–72.

    Article  CAS  PubMed  Google Scholar 

  26. Harada A, D'Agostino HJ Jr, Schuessler RB, Boineau JP, Cox JL. Potential distribution mapping. New method for precise localization of intramural septal origin of ventricular tachycardia. Circulation. 1988;78(5 Pt 2):III137–47.

    CAS  PubMed  Google Scholar 

  27. Lewis TMJ, White PD. The excitatory process in the Dog's heart. Part I. The Auricles. Philos Trans R Soc London B. 1914;205:375–420.

    Article  Google Scholar 

  28. Rokkas CK, Nitta T, Schuessler RB, Branham BH, Cain ME, Boineau JP, et al. Human ventricular tachycardia: precise intraoperative localization with potential distribution mapping. Ann Thorac Surg. 1994;57(6):1628–35.

    Article  CAS  PubMed  Google Scholar 

  29. Tweddell JS, Branham BH, Harada A, Stone CM, Rokkas CK, Schuessler RB, et al. Potential mapping in septal tachycardia. Evaluation of a new intraoperative mapping technique. Circulation. 1989;80(3 Pt 1):I97–108.

    CAS  PubMed  Google Scholar 

  30. Schuessler RB, Kay MW, Melby SJ, Branham BH, Boineau JP, Damiano RJ Jr. Spatial and temporal stability of the dominant frequency of activation in human atrial fibrillation. J Electrocardiol. 2006;39(4 Suppl):S7–12.

    Article  PubMed  Google Scholar 

  31. Gray RA, Pertsov AM, Jalife J. Spatial and temporal organization during cardiac fibrillation. Nature. 1998;392(6671):75–8.

    Article  CAS  PubMed  Google Scholar 

  32. Podziemski P, Zeemering S, Kuklik P, van Hunnik A, Maesen B, Maessen J, et al. Rotors detected by phase analysis of filtered, epicardial atrial fibrillation electrograms colocalize with regions of conduction block. Circ Arrhythm Electrophysiol. 2018;11(10):e005858.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Barnette AR, Bayly PV, Zhang S, Walcott GP, Ideker RE, Smith WM. Estimation of 3-D conduction velocity vector fields from cardiac mapping data. IEEE Trans Biomed Eng. 2000;47(8):1027–35.

    Article  CAS  PubMed  Google Scholar 

  34. Bayly PV, KenKnight BH, Rogers JM, Hillsley RE, Ideker RE, Smith WM. Estimation of conduction velocity vector fields from epicardial mapping data. IEEE Trans Biomed Eng. 1998;45(5):563–71.

    Article  CAS  PubMed  Google Scholar 

  35. Fitzgerald TN, Brooks DH, Triedman JK. Identification of cardiac rhythm features by mathematical analysis of vector fields. IEEE Trans Biomed Eng. 2005;52(1):19–29.

    Article  PubMed  Google Scholar 

  36. Lammers WJ, Schalij MJ, Kirchhof CJ, Allessie MA. Quantification of spatial inhomogeneity in conduction and initiation of reentrant atrial arrhythmias. Am J Phys. 1990;259(4 Pt 2):H1254–63.

    CAS  Google Scholar 

  37. Ishii Y, Schuessler RB, Gaynor SL, Yamada K, Fu AS, Boineau JP, et al. Inflammation of atrium after cardiac surgery is associated with inhomogeneity of atrial conduction and atrial fibrillation. Circulation. 2005;111(22):2881–8.

    Article  CAS  PubMed  Google Scholar 

  38. Millar CK, Kralios FA, Lux RL. Correlation between refractory periods and activation-recovery intervals from electrograms: effects of rate and adrenergic interventions. Circulation. 1985;72(6):1372–9.

    Article  CAS  PubMed  Google Scholar 

  39. Boineau JP, Schuessler RB, Mooney CR, Miller CB, Wylds AC, Hudson RD, et al. Natural and evoked atrial flutter due to circus movement in dogs. Role of abnormal atrial pathways, slow conduction, nonuniform refractory period distribution and premature beats. Am J Cardiol. 1980;45(6):1167–81.

    Article  CAS  PubMed  Google Scholar 

  40. Kim KB, Rodefeld MD, Schuessler RB, Cox JL, Boineau JP. Relationship between local atrial fibrillation interval and refractory period in the isolated canine atrium. Circulation. 1996;94(11):2961–7.

    Article  CAS  PubMed  Google Scholar 

  41. Hansen BJ, Zhao J, Fedorov VV. Fibrosis and atrial fibrillation: computerized and optical mapping; a view into the human atria at submillimeter resolution. JACC Clin Electrophysiol. 2017;3(6):531–46.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Ambrosi CM, Fedorov VV, Schuessler RB, Rollins AM, Efimov IR. Quantification of fiber orientation in the canine atrial pacemaker complex using optical coherence tomography. J Biomed Opt. 2012;17(7):071309.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Berbari EJL, Geselowitz P, Scherlag DB, Lazzara BJR. The methodology of cardiac mapping. In: Shenasa M, Borggrefe M, Breithardt G, editors. Cardiac mapping. Mount Kisco: Futura Publishing Company, Incd; 1993. p. 63–78.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Cardiothoracic Surgery Research Laboratory, Division of Cardiothoracic Surgery, Department of Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Richard B. Schuessler

Authors
  1. Richard B. Schuessler
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Richard B. Schuessler .

Editor information

Editors and Affiliations

  1. Department of Biomedical Engineering, The George Washington University, Washington, DC, USA

    Igor R. Efimov

  2. National Heart & Lung Institute, Imperial College London, London, UK

    Fu Siong Ng

  3. Philips EPD Solutions, Cambridge, MA, USA

    Jacob I. Laughner

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Schuessler, R.B. (2021). Extracellular Mapping of Arrhythmias. In: Efimov, I.R., Ng, F.S., Laughner, J.I. (eds) Cardiac Bioelectric Therapy. Springer, Cham. https://doi.org/10.1007/978-3-030-63355-4_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-63355-4_8

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-63354-7

  • Online ISBN: 978-3-030-63355-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation