Noninvascie technique for detection of electrical activity during the P-R segment

E. J. Berbari, R. Lazzara, P. Samet, B. J. Scherlag

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

Many recent clinical studies of the His Purkinje system have utilized intracardiac catheter recordings. This study describes a technique for recording activity of the ventricular specialized conduction system from the body surface. Unlike the standard electrocardiographic signals, approximately one mV at the body surface, the electrical activity of the His Purkinje system is in the microvolt range at the body surface. In 15 anesthetized dogs, His bundle electrograms, standard ECG recordings, and a highly amplified, filtered bipolar lead across the chest were recorded. The application of signal averaging to the surface leads allows for extraction of the periodic signal (His Purkinje activity) from random electrical moise. The heart was paced from the right atrium to insure periodicity of the heart rate and to obtain a valid average. By pacing at progressively higher rates, there was a progressive increase in the P-R segment, so that a series of potentials (defined here as the G complex) could be observed occurring prior to ventricular activity. The morphology and temporal relationships of His bundle (H) activity and the G complex to ventricular activity remained constant at all paced rates. HV times averaged 29±2 msec; correspondingly, the onset of G to V was 29±2 msec. Procainamide was used to alter His Purkinje conduction times. Comparison of the preventricular activity with the His bundle electrogram showed almost identical time intervals in the control and after drug administration, HV=37±3 msec. Thus by using the signal averaging technique, signals that are associated with the His Purkinje system can be detected on the body surface and validated in various experimental situations.

Original languageEnglish
Pages (from-to)1005-1013
Number of pages9
JournalCirculation
Volume48
Issue number5
StatePublished - Dec 1 1973
Externally publishedYes

Fingerprint

Cardiac Electrophysiologic Techniques
Cardiac Catheters
Procainamide
Bundle of His
Drug and Narcotic Control
Periodicity
Heart Atria
Electrocardiography
Thorax
Heart Rate
Dogs
Lead
Clinical Studies

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Berbari, E. J., Lazzara, R., Samet, P., & Scherlag, B. J. (1973). Noninvascie technique for detection of electrical activity during the P-R segment. Circulation, 48(5), 1005-1013.

Noninvascie technique for detection of electrical activity during the P-R segment. / Berbari, E. J.; Lazzara, R.; Samet, P.; Scherlag, B. J.

In: Circulation, Vol. 48, No. 5, 01.12.1973, p. 1005-1013.

Research output: Contribution to journalArticle

Berbari, EJ, Lazzara, R, Samet, P & Scherlag, BJ 1973, 'Noninvascie technique for detection of electrical activity during the P-R segment', Circulation, vol. 48, no. 5, pp. 1005-1013.
Berbari EJ, Lazzara R, Samet P, Scherlag BJ. Noninvascie technique for detection of electrical activity during the P-R segment. Circulation. 1973 Dec 1;48(5):1005-1013.
Berbari, E. J. ; Lazzara, R. ; Samet, P. ; Scherlag, B. J. / Noninvascie technique for detection of electrical activity during the P-R segment. In: Circulation. 1973 ; Vol. 48, No. 5. pp. 1005-1013.
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