Document Detail

Noninvasive recording of His-Purkinje activity in patients with complete atrioventricular block. Clinical application of an "automated discrimination circuit".
MedLine Citation:
PMID:  445759     Owner:  NLM     Status:  MEDLINE    
In seven patients with complete atrioventricular (AV) block, His bundle electrograms (HBEs), standard ECG recordings, bipolar esophageal ECGs and highly amplified, filtered, bipolar chest lead ECGs were simultaneously recorded. The filtered chest lead ECG was averaged to determine His-Purkinje activity (HPA). A simplified device, the "automated discrimination circuit," was used to selectively eliminate the superimposed atrial and ventricular potentials that are characteristic of complete AV block and unsuitable for signal averaging. The processed chest lead ECG was amenable to conventional techniques of signal averaging. In four patients with block proximal to the AV node diagnosed by HBE, there was no activity after the P wave in the surface-averaged ECGs. HPA was consistently recorded before the QRS in the surface-averaged ECG. The measurements of the HV and HPA-V intervals were very close, with a difference of less than 2 msec. Three patients with block distal to the His bundle by HBE showed a loss of electrical potential before the QRS in the surface-averaged ECG, but had a consistent HPA after the P waves. The P-HPA intervals coincided well with PH intervals, with a maximal difference of 5 msec.
H Takeda; K Kitamura; T Takanashi; T Tokuoka; H Hamamoto; T Katoh; I Niki; Y Hishimoto
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Circulation     Volume:  60     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1979 Aug 
Date Detail:
Created Date:  1979-09-01     Completed Date:  1979-09-01     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  421-6     Citation Subset:  AIM; IM    
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MeSH Terms
Action Potentials
Amplifiers, Electronic
Bundle of His / physiopathology*
Electrocardiography / instrumentation,  methods*
Electronics, Medical / instrumentation*
Heart Atria / physiopathology
Heart Block / physiopathology*
Heart Conduction System / physiopathology*
Purkinje Fibers / physiopathology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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