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Relationship between the most proximal His bundle and the morphology of intracavitary pressure curves

P Alboni1, S Scarfó, G F Baggioni

  • 1Division of Cardiology, Arcispedale S. Anna, Ferrara, Italy.

European Heart Journal
|October 1, 1989
PubMed

Insights

Accurate His bundle (HB) localization aids in modifying atrioventricular (AV) nodal conduction. This study correlates HB location with pressure curves, finding distinct H-V intervals for diagnostic and therapeutic leads.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Precise localization of the His bundle (HB) is crucial for diagnosing and treating atrioventricular (AV) nodal conduction abnormalities.
  • Bipolar leads are used for diagnosis, while unipolar leads are employed for therapy.

Purpose of the Study:

  • To investigate the relationship between the proximal His bundle's location and the morphology of intracavitary pressure curves.
  • To compare diagnostic (bipolar) and therapeutic (unipolar) lead recordings in relation to pressure dynamics.

Main Methods:

  • Continuous recording of bipolar and unipolar H-V intervals in 15 patients undergoing gradual catheter withdrawal from the right ventricle to the atrium.
  • Simultaneous monitoring of intracavitary pressure curves to correlate with electrograms.

Main Results:

  • Significant differences in longest and shortest H-V intervals were observed for both bipolar and unipolar recordings (P < 0.001).
  • H deflection was consistently observed with unipolar recordings alongside pressure curves.
  • Atrial H-V intervals were generally greater than transvalvular H-V intervals, particularly with unipolar leads, and H wave amplitude decreased towards the atrium.

Conclusions:

  • The study establishes a correlation between His bundle electrograms and intracavitary pressure curves, aiding in precise localization.
  • Findings support the use of different lead types for diagnostic and therapeutic interventions targeting the His bundle and AV conduction.

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