Incremental benefit of a novel signal recording system during mapping and ablation

Abstract

Aims Current electrophysiology signal recording and mapping systems have limited dynamic range (DR) and bandwidth, which causes loss of valuable information during acquisition of cardiac signals. We evaluated a novel advanced signal processing platform with the objective to obtain and assess additional information of clinical importance. Methods and results Over 10 canines, we compared intracardiac recordings within all cardiac chambers, in various rhythms, in pacing and during radiofrequency (RF) ablation across two platforms; a conventional system and the PURE EP™ [(PEP); Bio Sig Technologies, Inc., Los Angeles, CA, USA]. Recording cardiac signals with varying amplitudes were consistently and reproducibly observed, without loss of detail or introduction of artefact. Further the amplitude of current of injury (COI) on the unipolar signals correlated with the instantaneous contact force (CF) recorded on the sensing catheter in all the animals (r2 = 0.94 in ventricle). The maximum change in the unipolar COI correlated with the change in local electrogram amplitude during non-irrigated RF ablation (r2 = 0.61 in atrium). Reduction in artefact attributable to pacing (20 sites) and noise during ablation (48 sites) was present on the PEP system. Within the PEP system, simultaneous display of identical signals, filtered differently, aided the visualization of discrete conduction tissue signals. Conclusion Compared to current system, the PEP system provided incremental information including identifying conduction tissue signals, estimates of CF and a surrogate for lesion formation. This novel signal processing platform with increased DR and minimal front-end filtering may be useful in clinical practice.

Efficacy of Anti-Thrombogenic Coating in Decreasing the Rate of Clot Formation on Indwelling Intravascular Devices during Intra-Cardiac Ablation

“…However, once formed, cerebral protection devices (CPD) have proven their efficacy in capturing and containing thrombus and other emboli from the systemic circulation during intervascular interventions [9,[15][16][17][18][19][20]. Despite proving their efficacy in capturing embolic material, the use of these devices might be limited by dwell time due to the risk device clot occlusion or decreased blood flow [21].…”

Evaluation of a novel cardiac signal processing system for electrophysiology procedures: The PURE EP 2.0 study

“…Recently, the PURE EP™ system (BioSig Technologies) was introduced for this purpose and showed encouraging results in animal models. 10 This multi‐center, prospective study evaluated the overall quality and clinical relevance of PURE signals when compared to signals from conventional technology.…”