Intracardiac Electrogram Basics for Electrophysiology Studies
This infographic provides an overview of intracardiac electrograms, guiding practitioners through the steps necessary for electrophysiology (EP) studies.
Key Steps in Electrophysiology Studies
Place Catheters in Standard Positions:
- Catheters are placed at key anatomical sites, such as the high right atrium (HRA), His bundle area, coronary sinus (CS), and RV apex, to measure electrical activity.
Identify Near-Field (Sharp) Sensed Signals:
- The goal is to position the catheter so it captures sharp, local signals representing near-field myocardial activation.
- Catheters may be adjusted until an optimal signal is obtained.
Interpret the Sequence of Activation:
- The surface ECG reflects global activation, while intracardiac electrograms provide local myocardial activation.
- By aligning intracardiac signals with the surface ECG, the activation sequence (e.g., normal sinus rhythm) is determined.
Components of the Study
- Surface ECG: Captures electrical activity from the body’s surface, providing a global view of the heart’s rhythm.
- Intracardiac Electrograms: Record local activation at various points within the heart, revealing precise conduction patterns.
Example Activation Sequence
- HRA → His Bundle → Coronary Sinus → Ventricular Activation:
This sequence reflects normal sinus rhythm, with distinct signals from the atrium (A), His bundle (His), and ventricle (V).
Created by: Dr. Ramy Doss
Reviewed by: Dr. Kelly Arps
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