Non-invasive recording of His bundle potential in man. Simplified method

Area of Science:

• Cardiology
• Electrophysiology
• Medical Instrumentation

Background:

• Accurate measurement of His bundle to ventricle conduction time (HV) is crucial for diagnosing cardiac arrhythmias.
• Traditional methods for recording His bundle potentials can be complex and invasive.

Purpose of the Study:

• To develop and validate a simplified technique for recording His bundle potentials.
• To assess the accuracy of this new method in determining the HV interval.

Main Methods:

• Bipolar surface electrocardiograms were recorded simultaneously with intracavitary His bundle electrograms.
• Signal averaging techniques and specific electrode placements (cathode on posterior midline, anode on sternum) were employed.
• Surface electrocardiograms with a standard time constant were used to identify ventricular activation onset.

Main Results:

• 'Blips' representing His bundle potentials were successfully recorded between PR segments in 7 patients (6 sinus rhythm, 1 atrial fibrillation).
• Optimal recording was achieved with a specific electrode configuration at the fourth intercostal space.
• The interval from the recorded 'blip' to ventricular activation onset (BV) closely correlated with the directly measured HV interval, with a maximum difference of 1 ms.

Conclusions:

• This simplified His bundle recording technique allows for reliable measurement of the His bundle to ventricle conduction time.
• The method shows high accuracy and potential for clinical application in evaluating cardiac conduction disorders.