Clinical Electrophysiology -> Syncope & Bradycardia: -> Electrocardiography and Monitoring D-PO05 - Poster Session V (ID 39) Poster

D-PO05-213 - Non-invasive HV Detection Using New High-density Pre-amplified Electrodes Acquisition Method (ID 596)


Background: His potential has a high frequency but low amplitude signal which is not detected on standard surface ECG, HV interval is thus routinely measured invasively.
Objective: A new, non-invasive, high-density and high-fidelity acquisition method, using pre-amplified electrodes, can theoretically detect such subtle electrophysiological signal after signal averaging processing (BioSemi Active Two System). We wanted to assess the possibility of non-invasive HV interval measurement using this new device.
Methods: We conducted a prospective monocentric study at Bordeaux University Hospital in France to evaluate the correlation between the HV interval obtained invasively and non-invasively in patients hospitalized for programmed electrophysiology study. HV intervals were blindly acquired and measured. For non-invasive HV assessment, we used signal averaged standard bipolar and Laplacian electrodes. Correlation was assessed using parametric Pearson correlation coefficient.
Results: Thirty-five patients aged 53.1±16.5 years were included. Mean P wave duration was 62.8±12.3ms, PR duration was 204.6±51.0ms and QRS duration was 112.3±26.0ms. Patients were admitted for VF ablation in 17 (49%), Steinert disease assessment in 10 (29%), ischemic VT ablation in 4 (11%), syncope assessment in 3 (9%) and PVC ablation in 1 (3%). Mean invasive HV interval was 53.1±11.1ms. Non-invasive HV interval was obtained in 33 patients (94%), mean value was 55.3±19.3ms. In the other 2 patients, non-invasive signal has too poor quality to be interpreted. There was no complication related to either one or the other method. Pearson correlation coefficient was ρ=0.8465 [0.7094;0.9219] (p<0.0001).
Conclusion: There was very good correlation between invasive and non-invasive HV intervals measurements. Further signal processing optimization is needed to improve these results. It holds promises to non-invasively detect other low amplitude signals.