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Related Concept Videos

Conduction System of the Heart01:19

Conduction System of the Heart

10.1K
Autorhythmicity is a term that refers to the heart's inherent ability to generate electrical signals and instigate muscle contractions. This self-regulating conduction system within the heart consists of two key components: the pacemaker cells and specialized conducting cells.
The pacemaker cells are located in two primary nodes: the sinoatrial (SA) node and the atrioventricular (AV) node. The SA node pacemaker cells can autonomously depolarize, triggering an action potential that leads to the...
10.1K

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Related Experiment Video

Updated: Sep 27, 2025

Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction
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Ablation of Ischemic Ventricular Tachycardia Using a Multipolar Catheter and 3-dimensional Mapping System for High-density Electro-anatomical Reconstruction

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Intraoperative conduction mapping in complex congenital heart surgery.

Eric N Feins1, Edward T O'Leary2, David M Hoganson1

  • 1Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Mass.

JTCVS Techniques
|April 11, 2022
PubMed
Summary

Intraoperative mapping precisely locates the conduction system during complex congenital heart surgery. This novel technique helps surgeons avoid damaging critical pathways, reducing the risk of heart block and pacemaker dependence in children.

Keywords:
AVB, atrioventricular blockBiV, biventricularCAVC, complete atrioventricular canalHBE, His bundle electrogramHTX, heterotaxy syndromeIOM, intraoperative His bundle electrogram mappingLV, left ventricle

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Area of Science:

  • Cardiovascular Surgery
  • Electrophysiology
  • Pediatric Cardiology

Background:

  • Postoperative heart block is a major complication in congenital heart defect surgery.
  • Conduction system location is unpredictable in complex congenital heart defects.

Purpose of the Study:

  • To describe a novel technique for intraoperative conduction system mapping.
  • To evaluate the efficacy of this technique in complex congenital heart surgery.

Main Methods:

  • High-density multielectrode grid catheter used for intracardiac electrograms on open, beating hearts.
  • Real-time communication of conduction tissue location from electrophysiologists to surgeons.
  • Heart arrest and repair performed after mapping to avoid conduction system injury.

Main Results:

  • Mapping accurately identified conduction tissue location in two patients with complex heterotaxy syndrome.
  • Conduction system injury was avoided during biventricular repair in both patients.
  • Unexpected inferior conduction system location noted in one patient with L-looped ventricles.

Conclusions:

  • Intraoperative conduction mapping effectively localizes the conduction system during surgery.
  • This technique enables surgeons to avoid conduction system injury.
  • Reduced risk of heart block and need for pacemakers in pediatric congenital heart surgery.