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Related Experiment Videos

Left ventricular approach for recording His bundle potential in man.

Y S Lee, W P Lien

    Chest
    |June 1, 1975
    PubMed
    Summary

    This study demonstrates stable His bundle (HB) and left bundle branch (LB) potential recordings from the left ventricle. These left-sided recordings provide reliable electrophysiologic data comparable to right-sided measurements.

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    Area of Science:

    • Electrophysiology
    • Cardiology
    • Medical Imaging

    Background:

    • Accurate electrophysiological mapping is crucial for diagnosing cardiac conduction abnormalities.
    • Traditional His bundle electrograms (HBE) are typically recorded from the right ventricle.
    • Left ventricular endocardial recordings offer an alternative approach for assessing cardiac conduction.

    Purpose of the Study:

    • To evaluate the feasibility and reliability of recording His bundle (HB) and left bundle branch (LB) electrical potentials from the left ventricular endocardial surface.
    • To compare electrophysiological intervals measured from the left ventricle with those from the right ventricle.
    • To identify specific clinical scenarios where left-sided electrophysiological studies are indicated.

    Main Methods:

    • Recording His bundle (HB) and left bundle branch (LB) potentials using a bipolar electrode catheter from the left ventricular endocardial surface in 28 patients.
    • Measuring key electrophysiological intervals including P-A, A-H, H, H-V, LB, and LB-V.
    • Validating left-sided recordings through simultaneous intracardiac electrograms from both left and right sides of the heart in 18 patients.

    Main Results:

    • Stable recordings of HB and LB potentials were achieved from the left ventricular endocardium.
    • Average electrophysiological intervals (P-A, A-H, H, H-V, LB, LB-V) were determined in patients with normal A-V conduction.
    • Left-sided and right-sided recordings showed statistically similar interval values, with a slightly longer H potential duration from the left heart (P=0.05).
    • Simultaneous onset of H potentials and comparable LB-V and right bundle branch-ventricle (RB-V) conduction times were observed.

    Conclusions:

    • Left ventricular endocardial recordings provide a reliable method for obtaining His bundle (HB) and left bundle branch (LB) electrograms.
    • Left-sided electrophysiological measurements are comparable to right-sided measurements, offering a valuable alternative.
    • Left-sided studies are indicated when right-sided HB recording is not feasible, in cases of giant right atrium, or potentially during atrial fibrillation.

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