The effects of altering the conductivities of the boundary media at the endocardia 1 and epicardial surfaces of the ventricle on accession potentials in the ventricular wall and at its surfaces were studied in dogs. The amplitude of B at all points in the wall was decreased by any measure which increased the conductivity of the medium surrounding the heart or which decreased the conductivity of the medium in the ventricular cavity. The progression of R in the ventricular wall observed experimentally results, at least in part, from the differing conductivities of intracavitary blood, myocardium, and the medium surrounding the heart. A NALYSIS of the intrinsic deflection of the QRS complex yields the theoretical values of 27r0 a for the amplitude of R and 47r0 a for the potential difference from the zenith of R to the nadir of S.1 From this expression the amplitude of R at all points on an electrode inserted into the ventricular wall would be predicted to be uniform and approach the given value. However, the amplitude of R observed experimentally is nonuniform ; it is smallest at the endocardia! surface and progresses to its greatest magnitude at the epicardial surface.--:! It is possible that these deviations from the predicted value may be due to factors extrinsic to the accession moment 0 a . Thus, boundary conditions at the endocardial and epicardial surfaces of the ventricle may be important in modifying the recorded potentials during spread of accession from endocardium to epicardium. 4 The present experiments were designed to illustrate the influence of the conductivity of the media surrounding the heart and in its cavity on accession potentials in the wall and at the surfaces of the ventricles of the heart in situ.From the Department of Medicine, University of Oklahoma School of Medicine, and the Medical Service, Veterans Hospital, Oklahoma City, Oklahoma.Supported in part by grants-in-aid from the American Heart Association, National Heart Institute (Grant H-1889), and the Shipman Heart Research Fund.Work completed during Dr. Cuddy's tenure as a Diiland Fellow for Research in Clinical Medicine.Received for publication July 24, 3959.
82Methods Thirteen healthy mongrel clogs were anesthetized with pentobarbital sodium 25 nig./Kg. intravenously. The trachea was eannulated and ventilation maintained by a Harvard animal respirator. The heart was exposed through a midline sternotomy. A length of small polyethylene tubing was inserted into the left atrial appendage; the proximal end was fixed in place and the distal end was left free outside the chest. A femoral vein was eannulated similarly.Small electrodes were inserted perpendicularly into the anterior free walls of the ventricles so that the innermost point lay in the subendocardium and the outermost point touched the epicardial surface. Intermediate points lay in the ventricular wall. The electrodes were similar to those described previously. 5 The distance between the fixed points was 3 mm. in the left ventricle and 2 mm. in the right ventricle. Intracavit...