Recordings of His bundle and other conduction tissue potentials in children

Brodsky, Sidney J.; Mirowski, M.; Krovetz, L. Jerome; Rowe, Richard D.

doi:10.1016/s0022-3476(71)80059-8

Cited by 31 publications

(5 citation statements)

References 22 publications

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“…An example of conduction without a detectable electrographic sign is the spread of an impulse in the AV node. The possibility that the N deflection arises in the AV node has been widely discussed (Hoffman et al, 1960;Damato et al, 1970;Massumi, 1970;Brodsky et al, 1971;Mendez and Moe, 1972;Kupersmith et al, 1973;Narula, 1973), but in agreement with most authors (Hoffman et al, 1960;Mendez and Moe, 1972;Kupersmith et al, 1973;Narula, 1973;Narula, 1975a) we believe that it originates not in the AV node but in intra-atrial tracts and label it Tr, as proposed by Narula. Some authors attribute the absence of an AV node deflection to potentials too small to be recorded.…”

Section: Discussionsupporting

confidence: 87%

Disappearing His deflection. Electrophysiological evidence for conduction defect within the His bundle.

Csapo¹,

Weisswange²

1978

Heart

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A change in the voltage and character of the His bundle deflection following premature atrial stimuli was observed and analysed in 5 of 95 patients having intracardiac conduction studies because of AV conduction disturbances. Of these 5 patients, 3 had spontaneous block within the His bundle, 2 of them showing block in other segments of the conduction system. With increasing prematurity of programmed atrial stimuli, there was a progressive decrease in the voltage of the His deflection, followed by a split His deflection, and finally disappearance of the His deflection. The voltage of the His deflection was also reduced in sinus beats following spontaneous His bundle premature beats. Similarly, during atrial stimulation at increasing rates, the His deflection decreased in voltage, split, and finally disappeared, but when Wenckebach periods appeared the His deflection reappeared in the first paced beat after the dropped beat. The preceding H-H interval was the only electrophysiological variable consistently related to the changes in the His deflection. These changes in His deflection can be explained electrophysiologically as the result of a conduction disturbance within the His bundle. The clinical significance of the phenomenon is discussed. The occurrence of this phenomenon during a conduction study makes it difficult or even impossible to localise the AV block precisely.

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Section: Discussionsupporting

confidence: 87%

Disappearing His deflection. Electrophysiological evidence for conduction defect within the His bundle.

Csapo¹,

Weisswange²

1978

Heart

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“…11,12,14,22 However, the fact that our electrodes are 2 mm apart whereas in the catheter technic electrodes are 1-2 cm apart may be important. Since phase "0' of the AV nodal action potential rises slowly,23' 24 its upstroke extends over a relatively long distance and therefore the potential difference between closely adjacent extracellular electrodes might be too small to record.23 However, the wavelength of phase "0" of the AV nodal action potential (i.e., the distance over which the upstroke of the AV nodal action potential Circulation, Volume XLVII, April 1973 extends) may in fact be short enough for electrodes 2 mm apart to be able to record a potential difference produced during AV nodal depolarization.…”

Section: Av Nodal Electrogramsmentioning

confidence: 99%

Conduction Intervals and Conduction Velocity in the Human Cardiac Conduction System

1973

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Specialized fiber electrograms were recorded in 64 patients during open-heart surgery. Intervals were measured from the proximal His bundle, distal His bundle, and right and left bundle branches to the earliest QRS deflection in the limb lead ECG (pH-Q, dH-Q, RB-Q, and LB-Q interval, respectively). There was an increase of pH-Q intervals with increasing age such that at age 3 months the normal range of pH-Q interval was 13-27 msec, while at 14 years of age it was 32-54 msec. For patients 15 years of age and older, the normal range of pH-Q interval was 35-54 msec, similar to that reported by several investigators using catheter technic and suggesting that most His bundle electrograms recorded by catheter technic in fact record from the proximal His bundle. The dH-Q interval varied from 18 to 35 msec, the RB-Q interval from 18 to 30 msec, and the LB-Q interval from 20 to 39 msec. These normal ranges of RB-Q and LB-Q intervals are greater than previously reported. Overlaps existed between the normal range of pH-O and dH-Q or LB-Q intervals, dH-Q and RB-Q or LB-Q intervals and, at least in children, the pH-Q and RIB-Q intervals. Thus the timing of a specialized fiber electrogram does not necessarily reflect its anatomic location. AV nodal electrograms were not recorded although the recording sites included the known anatomic location of the AV node. Conduction velocity in the His bundle was determined and averaged 1.5 m/sec (range 1.3-1.7 m/sec).

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“…The first published experience with catheterization for His bundle recording in pediatrics appeared in a 1971 report from Brodsky and colleagues, which provided normal values for baseline conduction intervals from infancy through adolescence. 17 Shortly thereafter, Gillette provided refined data on intracardiac conduction in children by analyzing the response to programmed stimulation. 18 Intraoperative mapping was also initiated in children around this time by Dick et al, who performed detailed localization of the specialized conduction tissues during open heart surgery as a method of avoiding heart block in complex congenital malformations.…”

Section: Pioneers In Pediatric Electrophysiology (1970-1980s)mentioning

confidence: 99%

Section: Pioneers In Pediatric Electrophysiology (1970–1980s)mentioning

confidence: 99%

Research Accomplishments in Pediatric Electrophysiology: A Historical Review

Walsh

Dick

2013

Congenit Heart Dis

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Arrhythmia management in young patients plays a small but important role within the broader discipline of cardiac electrophysiology (EP). By virtue of its sharp focus on developmental cardiology, congenital heart defects, and hereditary channelopathies, pediatric EP has contributed in significant ways to improved understanding of rhythm disorders in patients of all ages. Scientific progress in the field was recently reviewed at the 2012 meeting of the Heart Rhythm Society, where historical details of pioneering investigations in pediatric EP were highlighted. In this article, we hope to summarize those details and acknowledge the roles of individuals and organizations that were instrumental in developing the subspecialty.

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Recordings of His bundle and other conduction tissue potentials in children

Cited by 31 publications

References 22 publications

Disappearing His deflection. Electrophysiological evidence for conduction defect within the His bundle.

Disappearing His deflection. Electrophysiological evidence for conduction defect within the His bundle.

Conduction Intervals and Conduction Velocity in the Human Cardiac Conduction System

Research Accomplishments in Pediatric Electrophysiology: A Historical Review

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