dipole - + measurement point chpt 2 sunny po.pdf · figure 2.10b. freq ampl freq ampl 1 1 low high...

Figure 2.1A.

+-+-+-+-+-+-+-+-

Measurement pointReference point at a

far distance

+-+-+-+-+-+-+-+-

Reference point at a

far distance

Measurement points

E1E2

Vbipolar = VE1 –VE2

Depolarization wave front

dipole

Figure 2.1B.

E+E-

Figure 2.2A. 100 ms

V1

II

HBp

HBd

CSd

CSp

I

HBm

21+, 22- 22+, 21-

Figure 2.2B. 100 ms

V1

II

CSp

I

CSd

MAPp

MAPd

UNI-1

UNI-2

21+, 6- 21-, 6+

Tip

Ring

Bipolar

Figure 2.3A.

Tip

Ring

Bipolar

Figure 2.3B.

Tip

Ring

Bipolar

Figure 2.3C.

Tip

Ring

Bipolar

Figure 2.3D.

Tip

Ring

Bipolar

Figure 2.3E.

Tip

Ring

Bipolar

Tip

Ring

Bipolar

Figure 2.3F.

QS

Pattern

QS

Pattern

Figure 2.4A.

Tip

Ring

Bipolar

Figure 2.4B.

+-+-+-+-+-+-+-+-

+-+-+-+-+-+-+-+-

Figure 2.5A.

Tip

Ring

Tip-Ring

Tip

Ring

Tip-Ring+

+

+-+

+

+-

Figure 2.5B.

Tip

Ring

Bipolar

Figure 2.6A.

Tip

Ring

Bipolar

Figure 2.6B.

Tip

Ring

Bipolar

Figure 2.6C.

Tip

Ring

Bipolar

Figure 2.6D.

Tip

Ring

Bipolar

Figure 2.6E.

Tip

Ring

Tip-Ring

Tip

Ring

Tip-Ring

Tip

Ring

Tip-Ring

Tip

Ring

Tip-Ring

Tip

Ring

Tip-Ring

1.

2.

3.

4.

5.

Figure 2.6F.

Figure 2.7A.

tip

ring

bipolar

Figure 2.7B.

Bipole

Pin 75-76

2 mm apart

Bipole

Pin 75-78

9 mm apart

Bipole

Pin 75-80

16 mm apart

=

+

t

+

0.6cos(2π120t)

1.7cos(2π50t)

x(t)

Figure 2.8A.

=

t

++

1cos(2π20t)

2cos(2π13t)

x(t)

=

Figure 2.8B.

+

+

+

=

0.6cos(2π120t)

1.7cos(2π50t)

1cos(2π20t)

2cos(2π13t)

x(t)

+

+

+

=

tFigure 2.8C.

frequency (Hz)

am

pli

tude

0.6cos(2π120t)

1.7cos(2π50t)

1cos(2π20t)

2cos(2π13t) Mathematical description

in time domain

Figure 2.8D.

filters

and

gain

• Analog pre-amplifier

• Highpass and Lowpass filters

• Gain

filters

and

gain

filters

and

gain

Anal

og

-to-D

igit

al

Conver

sion

Digitization

display

storage

Computer

Command

and Control

Stage 1 Stage 2

Intra-cardiac Signals

ECG Signals

Figure 2.9A.

Figure 2.9B.

IIV1

RAA

HBP

HBD

CSP

CSD

I

MAPP

MAPD

UNI-1

UNI-2

Noise

High signal-to-noise ratio (SNR))

Low SNR

Very Low SNR

Figure 2.10A.

Figure 2.10B.

freq

am

pl

freq

am

pl

1 1

low high low high

freq

am

pl

freq

am

pl

1 1

low high low high

Low Pass High Pass

Band Pass Band Reject

high

corner

frequency

low corner

frequency

lower

end

upper

end

frequency (Hz)

am

plit

ude

60 Hz

Figure 2.10C.

Figure 2.10D.

II

60 Hz notch filter off 60 Hz notch filter on

Figure 2.11A.

IIV1

RAA

HBP

HBD

CSP

CSD

1-250 Hz

I

MAPP

MAPD

30-250 Hz1-500 Hz

UNI-1

UNI-2

Unipolar

Filter

1 -500 Hz 0.1 - 500 Hz

IIV1

RAA

HBP

HBD

CSP

CSD

I

MAPP

MAPD

UNI-1

UNI-2

artifact

artifact

Unipolar

Filter

Figure 2.11B.

Figure 2.11C.

IIV1

RAA

HBP

HBD

CSP

CSD

I

MAPP

MAPD

0.1 - 500 Hz

UNI-1

UNI-2

Figure 2.11D.

IIV1

RAA

HBP

HBD

CSP

CSD

I

MAPP

MAPD

1 - 500 Hz

UNI-1

UNI-2

All frequencies below 80 Hz are

multiplied by 1, so they remain

as they are.

Filt

er

resp

on

se

am

plit

ud

e

All frequencies above 80 Hz

are multiplied by 0, so they

are eliminated.

Frequency (Hz)

EG

frequency c

om

positio

n a

mplitu

de

Figure 2.12A.

low corner

frequencyhigh corner

frequency

Am

plitu

de

Bandpass

Figure 2.12B.

60 Hz

59.6 Hz 60.4 Hz

60 Hz

ringing

ringing

ringing

Figure 2.12C.

frequency (Hz)

am

plitu

de

corner frequency

(100 Hz)

Figure 2.12D

Figure 2.13A

Original

electrogram

Filtered

electrogram

“noise” is

gonehigh-frequency peaks

attenuated and slurred

Time

Figure 2.13B

Raw Data

30-250 Hz filter

high frequency:

little change

lower frequency:

inversion of

morphology!

Time Phase delay

Raw Data

10-250 Hz

20-250 Hz

30-250 Hz

40-250 Hz

50-250 Hz

60-250 Hz

Time Figure 2.13C

Figure 2.13D

Noise-free data

Data with

60-Hz Noise

Notch Filter

Adaptive Filter

Time

Figure 2.14A 0.67 – 21 Hz

I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

Figure 2.14B.

I

II

III

aVR

aVL

aVF

V1

V2

V3

V4

V5

V6

Figure 2.14C

ECG filter: 0.05 - 100 HzECG filter: 1 - 100 Hz

Figure 2.14D

Figure 2.15A

Filter: 1-100 Hz

Figure 2.15B

Filter: 0.05-100 Hz

100 ms

RAA

HBP

HB3

HB2

HBd

HBd

Pin 7-8

Notch filter off

HBd

Pin 7-10

Notch filter off

HBd

Pin 7-10

Notch filter on

H/RB H/RB H/RBV

V

V

Figure 2.16A

100 ms

Electrodes:

2 mm apart

Adaptive filter on

Electrodes:

2 mm apart

Notch filter off

Electrodes:

2 mm apart

Notch filter on

Electrodes:

12 mm apart

Adaptive filter on

Electrodes:

12 mm apart

Notch filter off

Electrodes:

12 mm apart

Notch filter on

Figure 2.16B

100 msFigure 2.17A.

RAA

V1

II

HBp

HBd

I

MAPP

MAPd

UNI-1

UNI-2

Figure 2.17B. 100 ms

RAA

V1

II

HBp

HBd

I

MAPP

MAPd

UNI-1

UNI-2

Figure 2.18A

I

V1

RAA

HBP

HBD

CSP

CSD

LVP

LVD

I

V1

RAA

HBP

HBD

CSP

CSD

LVP

LVD

Figure 2.18B

RA LA

LL

Wilson’s Central Terminal

Figure 2.19A.

Figure 2.19B

Figure 2.19C

Noise on ECG ECG generated by Stimulator

Figure 2.19D

60 Hz notch filter off 60 Hz notch filter on

Figure 2.20A

Foot end of

x-ray table

Head end of

x-ray table

CARTO

Patient-Interface

Unit (PIU)

Bard

Pin Box

Boom

ThermoCool

saline pump

Bard amplifier

RF generator

Figure 2.20B.

Figure 2.20C

Figure 2.20D.

All cables stay above floor !

AC power supply

of CARTO-3 PIU

Figure 2.21A

Figure 2.21B

Figure 2.22A

Figure 2.22B

Figure source: Wikipedia

Figure 2.22C

Figure 2.22D

HEAD FOOT

0.2 mG

8 mG

0.9 mG

3 mG

mG = milli Gauss

X-ray system NOT turned on

Figure 2.23A.

HEAD FOOT

>100 mG

8 mG

6.9 mG

18 mG

mG = milli Gauss

X-ray system turned on

Figure 2.23B.

Tri-field meter

60 mG

0 mG

Zoll defibrillator 6-8 mGaussiv bump: 5-6 mGaussFigure 2.24A.

Flush tubing

Ceiling hanger

Figure 2.24B.

Figure 2.25A

MAPp

MAPd

60 Hz Filter Off 60 Hz Filter On

Figure 2.25B

MAPp

MAPd

60 Hz Filter Off Adaptive Filter On

Figure 2.25C

UNI-1

MAPd

0.17 mV

0.03 mV

Figure 2.25D

UNI-1

MAPd

0.09 mV 0.05 mV

RA LA

LL

Lead-I

Figure 2.26A.

RA LA

LL

Wilson’s Central Terminal

Figure 2.26B.

Figure 2.26C.

Figure 2.26D.

Figure 2.27A.

Figure 2.27B.

RAA

V1

II

HBp

HBd

CSd

CSp

I

MAPP

MAPd

UNI-1

UNI-2

Figure 2.27C.

Figure 2.27D.

RAAV1

II

HBp

HBd

CSd

CSp

I

MAPP

MAPd

UNI-1

UNI-2

Figure 2.28A.

RAAV1

II

HBp

HBd

CSd

CSp

I

MAPP

MAPd

UNI-1

UNI-2

Power Impedance Temperature

Figure 2.28B.

RAA

V1

II

HBp

HBd

I

MAPP

MAPd

CS p

CS 9

CS 8

CS d

Figure 2.29A.

RAA

V1

II

HBp

HBd

I

MAPP

MAPd

CS p

CS 9

CS 8

CS d

Figure 2.29B.

Figure 2.30A.

RAA

V1

II

HBp

HB3

I

HB2

HBd

BARD CARTO® 3

HBp: pin 13+ 14-

(7, 8)

(9,10

(11,12

Figure 2.30B.

HBp: pin 12, 14 HBp: pin 12, 13

RAA

V1

II

HBp

HB3

I

HB2

HBd

(7, 8)

(9,10)

(11,12)

RAA

V1

II

HBp

HBd

I

MAPP

MAPd

UNI-1

UNI-2

100 msFigure 2.31A.

100 ms

RAA

V1

II

HBp

HBd

I

MAPP

MAPd

UNI-1

UNI-2

Figure 2.31B.

100 ms

RAAV1

HBp

HBd

CSd

CSp

I

MAPP

MAPd

UNI-1

UNI-2

MAPd: Pin 1, 2 MAPp: Pin 3, 4

Figure 2.32A.

100 ms

RAAV1

HBp

HBd

CSd

CSp

I

MAPP

MAPd

UNI-1

UNI-2

MAPd: Pin 1, 3 MAPp: Pin 2, 4

Figure 2.32B.

200 ms

RV

RAAV1

II

HBp

HBd

CSd

CSp

I

MAPP

MAPd

UNI-1

UNI-2

Figure 2.33