A pilot study of cardiac electrophysiology catheters to map and pace bladder electrical activity

Abstract

Spontaneous low-amplitude electrical activity was detected in the bladder through the use of commercially available cardiac electrophysiology equipment. While these low-level signals could represent noise, the voltage, and morphology resemble detrusor muscle action potentials previously seen in animal studies. Pacing induced local electrical capture in the trigone but not the dome.

Cardiac electrophysiology catheters for electrophysiological assessments of the lower urinary tract—A proof of concept ex vivo study in viable ureters

“…In this work we use cardiac electrophysiology catheters and needle electrodes to provide quantitative values regarding propagation velocities, pacing threshold, activation patterns, and refractory time in the ureteric smooth muscle. Our study extends the results of two previous studies which provided qualitative insight on the use of commercially available cardiac electrophysiology equipment for detecting electrical activity in the urinary smooth muscle (bladder). To the best knowledge of the authors, the present work is the first in the lower urinary tract to: i) provide quantitative measurements of propagating electrical activity by means of catheter‐based electrodes, in a well‐defined ex vivo stimulation protocol; and ii) compare those recordings with conventional needle electrodes.…”

“…To the best of our knowledge, only two very recent studies have attempted the measurement of electrophysiological signals in the lower urinary tract using cardiac catheters. These investigations were done directly in vivo in urinary bladders of volunteers.…”

“…These investigations were done directly in vivo in urinary bladders of volunteers. Attempts of bladder pacing were conducted but only qualitative observations and hypotheses were discussed, no quantitative data on electrical activation and propagation of the electrical activity were provided.…”

Experience using multielectrode cardiac catheters for detection of electrophysiologic activity of the human urinary bladder

“…These catheters were placed into the bladder through the urethra, and electrical activity was measured. In our prior experience with quadripolar electrodes, we were able to demonstrate similar detectable electrical activity, in the microvolt range, in both the dome and the trigone in patients undergoing cystoscopy 11 . More sophisticated electrophysiologic catheters with numerous electrodes exist for the purposes of voltage mapping in patients with cardiac arrhythmias 12 .…”

“…In our prior experience with quadripolar electrodes, we were able to demonstrate similar detectable electrical activity, in the microvolt range, in both the dome and the trigone in patients undergoing cystoscopy. 11 More sophisticated electrophysiologic catheters with numerous electrodes exist for the purposes of voltage mapping in patients with cardiac arrhythmias. 12 This technology may be adapted to accurately assess bladder electrical activity.…”