Catheter Technique for Recording His Bundle Activity in Man

Scherlag, Benjamin J.; Lau, Sun H.; Helfant, Richard H.; Berkowitz, Walter D.; Stein, Emanuel; Damato, Anthony N.

doi:10.1161/01.cir.39.1.13

Cited by 984 publications

(147 citation statements)

References 9 publications

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“…Spontaneous heart block developed in one of the patients approximately 1 9 The present series is in general agreement with these previous studies. Of our 57 patients with LBBB, H-V was within the normal range (less than 50 msec) in 24%, intermediate (50-60 msec) in 37%, and prolonged (greater than 60 msec) in 39%.…”

Section: Electrophysiologic Findingssupporting

confidence: 93%

H-V Intervals in Left Bundle-Branch Block

1972

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SUMMARYl-V interval in left bundle-branch block (LBBB) Mean frontal axis was -8°+ 120 in group A, -16°-+-12°in group B, and -28°8°i n group C (NS). The frequent association of LBBB, normal H-V, and ASHD suggested the presence of isolated ischemic disease of the left bundle branch. In contrast, the frequent association of LBBB, prolonged H-V, and absence of ASHD was suggestive of sclerodegenerative bilateral bundle-branch disease. In a patient with LBBB, the occurrence of both first-degree A-V block and a QRS duration of 0.16 sec or greater strongly suggested the likelihood of H-V prolongation.

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Section: Electrophysiologic Findingssupporting

confidence: 93%

H-V Intervals in Left Bundle-Branch Block

1972

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“…In group II patients (8) A-V and V-A conduction appeared to be equal, whereas in group III (6), V-A conduction appeared to be "better" than A-V conduction. During retrograde refractory period studies, the A-V node had the longest ERP in ten patients (#1, 5,6,[8][9][10][11][12][13][14], the HPS in five (#2, 3, 15, 16, and 18) and the ventricular muscle in six (#4, 17, 19-21 and 23). In two patients (#7 and 22) it could not be determined whether maximum refractoriness existed in the A-V node or HPS.…”

Section: Retrograde Conduction Timesmentioning

confidence: 99%

“…Antegrade and retrograde refractory period studies were performed using the extrastimulus method (A2 or V2), at comparable basic cycle length (A1A1 or V1V1). 15 The coupling interval (A1A2 or V1V2) was progressively decreased (by [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] msec) up to the point of atrial or ventricular refractoriness. Stimuli were delivered through an isolation unit and care was taken to insure proper grounding of all equipment.…”

mentioning

confidence: 99%

A comparative analysis of antegrade and retrograde conduction patterns in man.

Akhtar¹,

Damato²,

Batsford³

et al. 1975

Circulation

168

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SUMMARYPatterns of antegrade and retrograde conduction and refractory periods were studied using His bundle electrogram recordings, incremental atrial and ventricular pacing and the extrastimulus technique. In 36/50 patients antegrade conduction was "better" than retrograde conduction (group I), as evidenced by a) onset of retrograde atrioventricular (A-V) 766 Materials and MethodsRight heart catheterization was performed in the nonsedated postabsorptive state using local anesthesia. Fifty patients were studied for basic electrophysiological characteristics; in 40 of these patients, antegrade and retrograde refractory periods were determined. The experimental nature of the procedure was explained to all patients and signed consents were obtained. Electrode catheters were percutaneously introduced and fluoroscopically positioned in the region of 1) the lateral wall of the right atrium near its junction with the superior vena cava, to record from and stimulate the region of the high right atrium; 2) the tricuspid valve, to record bundle of His and low atrial activity;'4 3) the right ventricular apex or outflow tract, for ventricular pacing. Standard ECG leads and intracardiac electrograms (filter frequency settings 40-500 Hz) and timelines generated at 10, 100 and 1000 msec were displayed on a multichannel oscilloscope and recorded on magnetic tape. The records were subsequently replayed and recorded on photographic paper at a speed of 150 mm/sec.Atrial and ventricular pacing were accomplished using a programmed digital stimulator capable of delivering rectangular impulses of 1.5 msec duration at an adjustable milliamperage. Minimum milliamperage which allowed reliable capture for atrial (less than 2 ma) and ventricular pacing (less than 1 ma) was used. Starting at a rate slightly faster than sinus rhythm, the rate of stimulation was

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“…The electrophysiological studies were performed by techniques described previously (Pimenta et al, 1980(Pimenta et al, , 1983Scherlag et al, 1969), with potential recordings from the high right atrium, left atrium (coronary sinus), and His bundle region, and endocavitary pacing, before and 20 minutes after intravenous injection of 5 mg of atenolol, while the patients were in sinus rhythm. The patients were subsequently followed in an outpatient clinic.…”

Section: Methodsmentioning

confidence: 99%

Effects of atenolol in patients with reciprocating supraventricular tachycardia

Pimenta

Pereira

1986

Clinical Cardiology

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Summary:We studied 12 patients with crisis of paroxysmal reciprocating supraventricular tachycardia before and after intravenous injection of 5 mg of atenolol. The patients were then followed for periods ranging from 6 to 50 months (median 34 months). During this time, they received oral atenolol therapy, at 200 mg for the first two weeks, and 100 mg daily thereafter. Tachycardia was due to reciprocation within the atrioventricular node in 9 patients, and to pre-excitation in 3 patients. Atenolol slowed the sinus rate, prolonged the atrioventricular conduction time, and increased the atrial cycle length at which atrioventricular nodal Wenckebach phenomenon occurred. During the tachycardia, atenolol increased the tachycardia cycle length, due to prolongation of the intranodal atrioventricular conduction time. Of the 11 patients who were observed for the full period, 7 had no further episodes of arrhythmia. One patient (with left-sided pre-excitation) failed to respond to any antiarrhythmic medication, one patient remained free of symptoms for two years, but received an atrial pacemaker for control of the tachycardia at the end of this period. Two patients (one with dual atrioventricular nodal pathways, and one with concealed leftsided pre-excitation) await other treatment for their tachycardia, after remaining free of symptoms for one and two years, respectively. These findings suggest that atenolol is an effective beta blocker for use in controlling arrhythmias in patients with reciprocating supraventricular tachycardia, for use in once daily dosage, and is a medication largely free of side effects.

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Catheter Technique for Recording His Bundle Activity in Man

Cited by 984 publications

References 9 publications

H-V Intervals in Left Bundle-Branch Block

H-V Intervals in Left Bundle-Branch Block

A comparative analysis of antegrade and retrograde conduction patterns in man.

Effects of atenolol in patients with reciprocating supraventricular tachycardia

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