ABSTRACT
It was established that the presence of Samoilov-Wenckebach's periods and prolongation of the H--V interval at low frequency of the imposed rhythm as well as periods of asystolia of more than 1,200 msec are most typical for these patients. An attempt was made to determine the type of cardiac stimulation indicated for such patients from the character of the disorders of rhythm observed in them and the initial frequency of their own cardiac contractions.
Subject(s)
Bundle of His/physiopathology , Heart Block/physiopathology , Heart Conduction System/physiopathology , Sinoatrial Block/physiopathology , Sinoatrial Node/physiopathology , Action Potentials , Aged , Bradycardia/etiology , Bundle-Branch Block/etiology , Cardiac Complexes, Premature/etiology , Electric Stimulation , Electrocardiography , Electrodes, Implanted , Female , Heart Atria , Heart Block/etiology , Humans , Male , Middle AgedABSTRACT
A method of cardiac microcatheterization introduced by the authors and effected by puncturing the left subclavian vein with a microcatheter of their original design permits recording the bundle of His electrogramme in a functional diagnosis study or in an intensive care ward. The bundle of His electrogramme was recorded in 107 patients, 72 of them having ischaemic heart disease, and 35 -- other cardiac lesions. The obtained data support the high diagnostic value of the bundle of His electrogramme, especially in determining the level of the atrioventricular block, of the reentry phenomenon, in differentiating abberant QRS complexes from ventricular extrasystoles, in diagnosing ectopic rhythms from different parts of the conductive system of the heart, and other complicated arrhythmias. The bundle of His electrogramme can be also used for the study of the effect of drugs on the conductivity function.
Subject(s)
Arrhythmias, Cardiac/diagnosis , Bundle of His/physiopathology , Coronary Disease/diagnosis , Heart Conduction System/physiopathology , Action Potentials , Adolescent , Adult , Aged , Arrhythmias, Cardiac/physiopathology , Cardiac Catheterization/methods , Child , Child, Preschool , Coronary Disease/physiopathology , Electrocardiography/methods , Evaluation Studies as Topic , Female , Humans , Male , Middle AgedABSTRACT
The authors describe their own method of right heart microcatheterization by means of transcutaneous introduction of an original unipolar microcatheter into the left subclavian vein. The method makes possible recording of th His bundle electrogram as well as of spike potentials of the sinus node and atrial conduction pathways. His bundle electrograms were recorded in 237 subjects, of whom 72 had ischaemic heart disease and 115 suffered from other cardiopathies, 50 persons with non-cardiac diseases constituted the control group. The high diagnostic value of His bundle electrogram was confirmed, especially in appraising the degree of A-V block, differentiation between aberrant QRS complexes and ventricular extrasystolia, and in other arrhythmias. Recording of spike potentials of the sinus node, atrial conduction pathways, and His bundle, and determination of the interposed intervals allow selective assessments of the impulse propagation velocities in individual segments of heart conduction system, especially on drug administration, and offer valuable information on the genesis of various types of arrhythmias and conduction disturbances.
