A methodology is described for noninvasive recording of the electrical activity generated by the His-Purkinje system of man utilizing filtering, high amplification, and signal averaging. A waveform ranging between 1 and 10mu V was observed during the P-R segment. In many individuals, there was temporal overlap between the terminal P wave and the initial portion of the His-Purkinje waveform. In ten patients with long P-R intervals there was a strong correlation (r greater than 0.95) between the H-V time measured by electrode catheter and the duration of the His-Purkinje waveform. In two patients with atrial fibrillation the resultant His-Purkinje waveform was similar in morphology and duration to those observed in the ten patients. In each group H-V time was determined noninvasively and a waveform associated with electrical activation of the major portions of the His-Purkinje system was obtained.
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http://dx.doi.org/10.1161/01.cir.54.2.219 | DOI Listing |
Med Eng Phys
September 2022
Department of Engineering, Campus Bio-Medico University of Rome, Rome, 00128, Italy.
His bundle pacing (HBP) has emerged as a feasible alternative to right (RVP) and biventricular pacing (BVP) for Cardiac Resynchronization Therapy (CRT). This study sought to assess, in ex-vivo experimental models, the optimal setup for HBP in terms of electrode placement and pacing protocol to achieve superior electrical synchrony in the case of complete His-Purkinje block and left bundle branch block (LBBB). We developed a 3D model of His bundle and bundle branches, embedded in a patient-specific biventricular heart model reconstructed from CT images.
View Article and Find Full Text PDFJ Cardiovasc Electrophysiol
November 2019
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Aims: His bundle pacing (HBP) is a feasible and reliable alternative to conventional right ventricular pacing (RVP), but associated ECG (electrocardiogram) changes have not been well-studied. This study aimed to determine the mechanisms underlying ECG changes associated with HBP using patient-specific multiscale heart simulations.
Methods: ECGs were recorded in two patients who were treated by HBP under a native rhythm and HBP at high and low voltages.
Dev Dyn
June 2005
Heart & Vascular Research Center, MetroHealth Campus, Case Western Reserve University, Cleveland, Ohio 44106-6011, USA.
Major difficulties investigating the developing cardiac conduction system stem from that the embryonic heart is extremely small (< 2 mm) and cardiac activation is relatively rapid (< 8 msec). The objective of this study was to investigate the electrophysiology of the embryonic chick cardiac conduction system at periseptation stages with a photodiode array-based detection method of optical mapping capable of high spatial and temporal resolution. Previous work indicated that, in chicken embryos, a switch occurs in ventricular activation pattern from immature base-to-apex to mature apex-to-base pattern at the time of ventricular septation.
View Article and Find Full Text PDFCirc Res
September 2003
Department of Pharmacology, SUNY Upstate Medical University, Syracuse, NY 13210, USA.
Transjunctional voltage regulates cardiac gap junctional conductance, but the kinetics of inactivation were considered too slow to affect cardiac action potential propagation. Connexin43 (Cx43) is abundantly expressed in the atrial and ventricular myocardium and the rapid ventricular conduction tissues (ie, His-Purkinje system) of the mammalian heart and is important to conduction through these cardiac tissues. The kinetics of Cx43 voltage gating were examined at peak action potential voltages using simulated ventricular myocardial action potential waveforms or pulse protocols exceeding 100-mV transjunctional potentials.
View Article and Find Full Text PDFPacing Clin Electrophysiol
December 1990
Section of Cardiology, Medical College of Georgia, Augusta 30912-3105.
The focus of this report is to describe a system for recording surface His-Purkinje and ventricular late potentials on a beat-by-beat basis outside of a shielded environment. An AC magnetic field monitoring device was designed for improved site selection, orientation, and quality control of the acquisition. His-Purkinje signals are detected utilizing spatial averaging and specific channel selection algorithms applied to discriminate random noise from signal.
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