Electrode Catheters and the Diagnostic Application of Intracardiac Electrography in Small Children

Abstract

The history of intracardiac electrography has been reviewed with particular reference to its practical application. The increasing versatility of electrode catheters is stressed and a new multipurpose diagnostic catheter with a platinum electrode is described. Electrograms chosen from 500 consecutive cases have been presented to demonstrate the use of an intracardiac lead during routine cardiac catheterization, and the special value of this technic in the investigation of congenital heart disease in babies and small children is emphasized.

Intracardiac electrocardiogram in endomyocardial fibrosis.

“…Kossmann et al (1950) preferred the term "demarcation potential", and considered that it was the result of a partial or complete block of the depolarization process near the pressure-making electrode. Watson (1964) considered that these S-T elevations should be referred to as contact, rather than injury, currents. In severe right ventricular endomyocardial fibrosis the contracted "apical region", lined with its thick fibrous tissue, often lies high up and just to the left of the spine in the postero-anterior fluoroscopic view (Fig.…”

“…1955; Watson, 1964). We report here a study of the application of intracardiac electrocardiograpliy to the investigation and diagnosis of endomyocardial fibrosis affecting the right ventricle predominantly.…”

Heart

“…Watson (236) reviewed the history of electrography and its clinical application, and described a n'ew multipurpose diagnostic catheter with a platinum electrode which is currently under development. Clinical cases were presented to document the value of an intracardiac lead during routine cardiac catheterization in the diagnosis of congenital heart disease in babies and children.…”

Right Ventricular Pressure Flow Relationships and Intracardiac Venturi Effects in Fallot's Tetralogy

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Recent studies of pressure flow relationships in isolated pulmonary valvular stenosis have demonstrated that, broadly speaking, they conform to certain well-known physical laws (Watson et al, 1960;Watson and Lowe, 1962), and a better understanding of right ventricular function in that condition has prompted us to make a similar study in patients with Fallot's tetralogy.Since there is still some disagreement about which cases should rightly be grouped under this title (Rosenblum et al, 1962;Coelho et al, 1961), we have considered only the so-called "classical" cases in our analysis: those with pulmonary stenosis, either valvular, infundibular, or both, and the characteristic ventricular septal defect that allows blood to pass freely from the right ventricle into an overriding aorta. When compared with those having a normal aortic root and an intact interventricular septum, it is obvious that the presence of this defect modifies the h1modynamic effects of obstruction to the outflow of blood from the right side of the heart.

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