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His Bundle Recording in Acquired Conduction Disease

His Bundle Recording in Acquired Conduction Disease Abstract Scherlag and co-workers1 introduced a simple technique for recording the electrical activity of the His bundle in the human heart. The technique consisted of passing an electrode catheter to the area of the tricuspid valve. With proper catheter positioning, amplification, and appropriate frequency filtering, the bundle of His potential could be reliably recorded. The His bundle catheter records an atrial, His bundle (H), and ventricular electrogram (Fig 1). Recording of H potentials allows subdivision of the PR interval into three subintervals. These are the following: PA, from the onset of the surface P wave to the onset of the low right atrial electrogram; AH, from the low right atrial electrogram to the onset of the first high frequency potential of the His bundle electrogram; and HV, from the H potential to the onset of surface QRS. The PA, AH, and HV intervals are, respectively, measures of intra-atrial (from high References 1. Scherlag BJ, Lau SH, Helfant RH, et al: Catheter technique for recording bundle activity in man. Circulation 39:13-18, 1969.Crossref 2. Dhingra RC, Rosen KM, Rahimtoola SH: Normal conduction intervals and responses in 61 patients using His bundle recording and atrial pacing. Chest 64:55-59, 1973.Crossref 3. Rosen KM, Rahimtoola SH, Chuquimia R, et al: Electrophysiological significance of first degree atrioventricular block with intraventricular conduction disturbance. Circulation 43:491-502, 1971.Crossref 4. Denes P, Wu D, Dhingra R, et al: The effects of cycle length on cardiac refractory periods in man. Circulation 49:32-41, 1974.Crossref 5. Rosen KM, Rahimtoola SH, Gunnar RM, et al: Site of heart block as defined by His bundle recording: Pathological correlations in three cases. Circulation 45:965-987, 1972.Crossref 6. Rosen KM, Dhingra RC, Loeb HS, et al: Chronic heart block in adults: Clinical and electrophysiological observations. Arch Intern Med 131:663-672, 1973.Crossref 7. Rosenbaum MB, Elizari MV, Lazzari JO: The Hemiblocks . Oldsmar, Fla, Tampa Tracings, 1970. 8. Lenegre J: Etiology and pathology of bilateral bundle branch block in relation to complete heart block. Prog Cardiovasc Dis 6:409-444, 1964.Crossref 9. Lev M: Anatomic basis for atrioventricular block. Am J Med 37:742-748,1964.Crossref 10. Haft JI, Weinstock M, Deguia R, et al: Assessment of atrioventricular conduction in left and right bundle branch block using His bundle electrograms and atrial pacing. Am J Cardiol 27:474-480, 1971.Crossref 11. Berkowitz WD, Lau SH, Patton RD, et al: The use of His bundle recordings in the analysis of unilateral and bilateral bundle branch block. Am Heart J 81:340-350, 1971.Crossref 12. Ranganathan N, Dhurandhar R, Phillips JH, et al: His bundle electrogram in bundle branch block. Circulation 45:282-294, 1972.Crossref 13. Rosen KM, Ehsani AE, Rahimtoola SH: H-V intervals in left bundle branch block, clinical and electrocardiographic correlations. Circulation 46:717-723, 1972.Crossref 14. Narula OS, Samet P: Right bundle branch block with normal, left or right axis deviation; analysis by His bundle recordings. Am J Med 51:432-455, 1971.Crossref 15. Denes P, Dhingra RC, Wu D, et al: The H-V interval in patients with bifascicular block (RBBB and LAD): Clinical, electrocardiographic and electrophysiologic correlations. Am J Cardiol , to be published. 16. Levites R, Haft JI: Significance of first degree heart block (prolonged P-R interval) in bifascicular block. Am J Cardiol 34:259-264, 1974.Crossref 17. Savage H, Dhingra RC, Chuquimia R, et al: Short term prospective follow up of patients with chronic right bundle branch block and left posterior hemiblock, abstracted. Circulation 50:244, 1974. 18. Lasser RP, Haft JI, Freidbergck: Relationship of right bundle branch block and marked left axis deviation (with left parietal or peri-infarction block) to complete heart block and Adams-Stokes syndrome. Br Heart J 37:429-437, 1968. 19. Kulbertus H, Collignon P: Association of right bundle branch block with left superior or inferior intraventricular block: Its relationship to complete heart block and Adams-Stokes Syndrome. Br Heart J 31:435-440, 1969.Crossref 20. Touboul P, Ibrahim M: Atrioventricular conduction defects in patients presenting with syncope and normal P-R interval. Br Heart J 34:1005-1011, 1972.Crossref 21. Scheinman M, Weiss A, Kunkel F: His bundle recordings in patients with bundle branch block and transient neurologic symptoms. Circulation 48:322-330, 1973.Crossref 22. Dhingra RC, Denes P, Wu D, et al: Syncope in patients with chronic bifascicular block: Significance, causative mechanisms and clinical implications. Ann Intern Med 81:302-306, 1974.Crossref 23. Schloff LD, Adler L, Donoso E, et al: Bilateral bundle branch block, clinical and electrocardiographic aspects. Circulation 35:790-801, 1967.Crossref 24. Scanlon PJ, Pryor R, Blount SG: Right bundle branch block associated with left superior or inferior intraventricular block: Clinical setting, prognosis and relation to complete heart block. Circulation 42:1123-1133, 1970.Crossref 25. DePasquale NP, Bruno MS: Natural history of combined right bundle branch block and left anterior hemiblock (bilateral bundle branch block). Am J Med 54:297-303, 1973.Crossref 26. Stock RJ, Macken DL: Observations on heart block during continuous electrocardiographic monitoring in myocardial infarction. Circulation 38:993-1005, 1968.Crossref 27. Rosen KM, Loeb HS, Chuquimia R, et al: Site of heart block in acute myocardial infarction. Circulation 42:925-933, 1970.Crossref 28. Hunt D, Sloman G: Bundle branch block in acute myocardial infarction. Br Med J 1:85-88, 1969.Crossref 29. Norris RM, Croxson MS: Bundle branch block in acute myocardial infarction. Am Heart J 79:728-733, 1970.Crossref 30. Lie KI, Wellens HJ, Schuilenburg RM, et al: Factors influencing prognosis of bundle branch block complicating acute anteroseptal infarction: The value of His bundle recordings. Circulation 50:935-941 1974.Crossref 31. Damato AN, Lau SH, Helfant R, et al: A study of heart block in man using His bundle recordings. Circulation 39:297-305, 1969.Crossref 32. Narula OS, Scherlag BJ, Samet P, et al: Atrioventricular block: Localization and classification by His bundle recordings. Am J Med 50:146-165, 1971.Crossref 33. Narula OS, Samet P: Wenckebach and Mobitz type II A-V block due to block within the His bundle and bundle branches. Circulation 41:947-965, 1970.Crossref 34. Schuilenburg RM, Durrer D: Conduction disturbances located within the His bundle. Circulation 45:612-628, 1972.Crossref 35. Dhingra RC, Denes P, Wu D, et al: The significance of second degree atrioventricular block and bundle branch block: Observations regarding site and type of block. Circulation 49:638-646, 1974.Crossref 36. Rosen KM, Loeb HS, Gunnar RM, et al: Mobitz type II block without bundle branch block. Circulation 44:1111-1119, 1971.Crossref 37. Rosen KM: The contribution of His bundle recordings to the understanding of cardiac conduction in man. Circulation 43:961-966, 1971.Crossref 38. Rosen KM, Gunnar RM, Rahimtoola SH: Site and type of second degree A-V block. Chest 61:99-100, 1972.Crossref 39. Norris RM: Heart block in posterior and anterior myocardial infarction. Br Heart J 31:352-356, 1969.Crossref 40. Davies MJ: Pathology of Conducting Tissue of the Heart . New York, Appleton-Century-Crofts, 1971. 41. Rosen KM, Catheter recordings of His bundle electrogram. Mod Conc Cardiovasc Dis 42:23-28, 1973. 42. Dhingra RC, Winslow E, Pouget JM, et al: The effect of isoproterenol on atrioventricular and intraventricular conduction. Am J Cardiol 32:629-636, 1973.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Internal Medicine American Medical Association

His Bundle Recording in Acquired Conduction Disease

Archives of Internal Medicine , Volume 135 (3) – Mar 1, 1975

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Publisher
American Medical Association
Copyright
Copyright © 1975 American Medical Association. All Rights Reserved.
ISSN
0003-9926
eISSN
1538-3679
DOI
10.1001/archinte.1975.00330030047005
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Abstract

Abstract Scherlag and co-workers1 introduced a simple technique for recording the electrical activity of the His bundle in the human heart. The technique consisted of passing an electrode catheter to the area of the tricuspid valve. With proper catheter positioning, amplification, and appropriate frequency filtering, the bundle of His potential could be reliably recorded. The His bundle catheter records an atrial, His bundle (H), and ventricular electrogram (Fig 1). Recording of H potentials allows subdivision of the PR interval into three subintervals. These are the following: PA, from the onset of the surface P wave to the onset of the low right atrial electrogram; AH, from the low right atrial electrogram to the onset of the first high frequency potential of the His bundle electrogram; and HV, from the H potential to the onset of surface QRS. The PA, AH, and HV intervals are, respectively, measures of intra-atrial (from high References 1. Scherlag BJ, Lau SH, Helfant RH, et al: Catheter technique for recording bundle activity in man. Circulation 39:13-18, 1969.Crossref 2. Dhingra RC, Rosen KM, Rahimtoola SH: Normal conduction intervals and responses in 61 patients using His bundle recording and atrial pacing. Chest 64:55-59, 1973.Crossref 3. Rosen KM, Rahimtoola SH, Chuquimia R, et al: Electrophysiological significance of first degree atrioventricular block with intraventricular conduction disturbance. Circulation 43:491-502, 1971.Crossref 4. Denes P, Wu D, Dhingra R, et al: The effects of cycle length on cardiac refractory periods in man. Circulation 49:32-41, 1974.Crossref 5. Rosen KM, Rahimtoola SH, Gunnar RM, et al: Site of heart block as defined by His bundle recording: Pathological correlations in three cases. Circulation 45:965-987, 1972.Crossref 6. Rosen KM, Dhingra RC, Loeb HS, et al: Chronic heart block in adults: Clinical and electrophysiological observations. Arch Intern Med 131:663-672, 1973.Crossref 7. Rosenbaum MB, Elizari MV, Lazzari JO: The Hemiblocks . Oldsmar, Fla, Tampa Tracings, 1970. 8. Lenegre J: Etiology and pathology of bilateral bundle branch block in relation to complete heart block. Prog Cardiovasc Dis 6:409-444, 1964.Crossref 9. Lev M: Anatomic basis for atrioventricular block. Am J Med 37:742-748,1964.Crossref 10. Haft JI, Weinstock M, Deguia R, et al: Assessment of atrioventricular conduction in left and right bundle branch block using His bundle electrograms and atrial pacing. Am J Cardiol 27:474-480, 1971.Crossref 11. Berkowitz WD, Lau SH, Patton RD, et al: The use of His bundle recordings in the analysis of unilateral and bilateral bundle branch block. Am Heart J 81:340-350, 1971.Crossref 12. Ranganathan N, Dhurandhar R, Phillips JH, et al: His bundle electrogram in bundle branch block. Circulation 45:282-294, 1972.Crossref 13. Rosen KM, Ehsani AE, Rahimtoola SH: H-V intervals in left bundle branch block, clinical and electrocardiographic correlations. Circulation 46:717-723, 1972.Crossref 14. Narula OS, Samet P: Right bundle branch block with normal, left or right axis deviation; analysis by His bundle recordings. Am J Med 51:432-455, 1971.Crossref 15. Denes P, Dhingra RC, Wu D, et al: The H-V interval in patients with bifascicular block (RBBB and LAD): Clinical, electrocardiographic and electrophysiologic correlations. Am J Cardiol , to be published. 16. Levites R, Haft JI: Significance of first degree heart block (prolonged P-R interval) in bifascicular block. Am J Cardiol 34:259-264, 1974.Crossref 17. Savage H, Dhingra RC, Chuquimia R, et al: Short term prospective follow up of patients with chronic right bundle branch block and left posterior hemiblock, abstracted. Circulation 50:244, 1974. 18. Lasser RP, Haft JI, Freidbergck: Relationship of right bundle branch block and marked left axis deviation (with left parietal or peri-infarction block) to complete heart block and Adams-Stokes syndrome. Br Heart J 37:429-437, 1968. 19. Kulbertus H, Collignon P: Association of right bundle branch block with left superior or inferior intraventricular block: Its relationship to complete heart block and Adams-Stokes Syndrome. Br Heart J 31:435-440, 1969.Crossref 20. Touboul P, Ibrahim M: Atrioventricular conduction defects in patients presenting with syncope and normal P-R interval. Br Heart J 34:1005-1011, 1972.Crossref 21. Scheinman M, Weiss A, Kunkel F: His bundle recordings in patients with bundle branch block and transient neurologic symptoms. Circulation 48:322-330, 1973.Crossref 22. Dhingra RC, Denes P, Wu D, et al: Syncope in patients with chronic bifascicular block: Significance, causative mechanisms and clinical implications. Ann Intern Med 81:302-306, 1974.Crossref 23. Schloff LD, Adler L, Donoso E, et al: Bilateral bundle branch block, clinical and electrocardiographic aspects. Circulation 35:790-801, 1967.Crossref 24. Scanlon PJ, Pryor R, Blount SG: Right bundle branch block associated with left superior or inferior intraventricular block: Clinical setting, prognosis and relation to complete heart block. Circulation 42:1123-1133, 1970.Crossref 25. DePasquale NP, Bruno MS: Natural history of combined right bundle branch block and left anterior hemiblock (bilateral bundle branch block). Am J Med 54:297-303, 1973.Crossref 26. Stock RJ, Macken DL: Observations on heart block during continuous electrocardiographic monitoring in myocardial infarction. Circulation 38:993-1005, 1968.Crossref 27. Rosen KM, Loeb HS, Chuquimia R, et al: Site of heart block in acute myocardial infarction. Circulation 42:925-933, 1970.Crossref 28. Hunt D, Sloman G: Bundle branch block in acute myocardial infarction. Br Med J 1:85-88, 1969.Crossref 29. Norris RM, Croxson MS: Bundle branch block in acute myocardial infarction. Am Heart J 79:728-733, 1970.Crossref 30. Lie KI, Wellens HJ, Schuilenburg RM, et al: Factors influencing prognosis of bundle branch block complicating acute anteroseptal infarction: The value of His bundle recordings. Circulation 50:935-941 1974.Crossref 31. Damato AN, Lau SH, Helfant R, et al: A study of heart block in man using His bundle recordings. Circulation 39:297-305, 1969.Crossref 32. Narula OS, Scherlag BJ, Samet P, et al: Atrioventricular block: Localization and classification by His bundle recordings. Am J Med 50:146-165, 1971.Crossref 33. Narula OS, Samet P: Wenckebach and Mobitz type II A-V block due to block within the His bundle and bundle branches. Circulation 41:947-965, 1970.Crossref 34. Schuilenburg RM, Durrer D: Conduction disturbances located within the His bundle. Circulation 45:612-628, 1972.Crossref 35. Dhingra RC, Denes P, Wu D, et al: The significance of second degree atrioventricular block and bundle branch block: Observations regarding site and type of block. Circulation 49:638-646, 1974.Crossref 36. Rosen KM, Loeb HS, Gunnar RM, et al: Mobitz type II block without bundle branch block. Circulation 44:1111-1119, 1971.Crossref 37. Rosen KM: The contribution of His bundle recordings to the understanding of cardiac conduction in man. Circulation 43:961-966, 1971.Crossref 38. Rosen KM, Gunnar RM, Rahimtoola SH: Site and type of second degree A-V block. Chest 61:99-100, 1972.Crossref 39. Norris RM: Heart block in posterior and anterior myocardial infarction. Br Heart J 31:352-356, 1969.Crossref 40. Davies MJ: Pathology of Conducting Tissue of the Heart . New York, Appleton-Century-Crofts, 1971. 41. Rosen KM, Catheter recordings of His bundle electrogram. Mod Conc Cardiovasc Dis 42:23-28, 1973. 42. Dhingra RC, Winslow E, Pouget JM, et al: The effect of isoproterenol on atrioventricular and intraventricular conduction. Am J Cardiol 32:629-636, 1973.Crossref

Journal

Archives of Internal MedicineAmerican Medical Association

Published: Mar 1, 1975

References