Value of Mini Electrodes for Mapping Myocardial Arrhythmogenic Substrate—The Influence of Tip-to-Tissue Angulation and Irrigation Flow on Signal Quality

Abstract

Background: The use of mini electrodes with a small surface and narrow electrode-to-electrode spacing is believed to lead to a higher electrical resolution. Until now, the effects of tip-to-tissue contact, angulation, and irrigation on signal quality and morphology are unknown. Methods: The beating heart of an open-chest pig was examined while controlling the angulation and contact between the catheter tip and myocardial tissue, as well as the irrigation of the catheter tip. The mini electrodes were mounted onto commercially available 8 mm non-irrigated and 4 mm irrigated tip catheters. Different electrode interconnections, angulations, contact forces, and irrigation flow were analyzed and compared to signals recorded from conventional electrodes. Results: A total of 63 electrode samples of 21 defined, stable settings, each lasting 30 s, were analyzed. (1) Tissue contact of mini electrodes was given as soon as the conventional tip electrode showed tissue contact. (2) Angulation of the tip-to-tissue contact showed a trend towards changes in the integral of signals derived from mini electrodes, and no significant changes were seen in signals derived from conventional or mini electrodes. (3) Irrigation flow surrounding the mini electrodes did not influence signals derived from mini electrodes, whereas conventional electrodes showed signals with a longer duration under higher irrigation. Conclusion: Mini electrodes are robust to contact force and irrigation flow regarding signal quality, whereas signals of conventional electrodes are affected by irrigation flow, leading to substantial changes in signal duration and kurtosis. Signals of mini electrodes are sensitive to local electrical changes because of a high local resolution.