The His-Purkinje electrocardiogram in man: an initial assessment of its uses and limitations.
A methodology is described for noninvasive recording of the electrical activity generated by the His-Purkinje system of man utilizing filtering, high amplification, and signal averaging. A waveform ranging between 1 and 10mu V was observed during the P-R segment. In many individuals, there was temporal overlap between the terminal P wave and the initial portion of the His-Purkinje waveform. In ten patients with long P-R intervals there was a strong correlation (r greater than 0.95) between the H-V time measured by electrode catheter and the duration of the His-Purkinje waveform. In two patients with atrial fibrillation the resultant His-Purkinje waveform was similar in morphology and duration to those observed in the ten patients. In each group H-V time was determined noninvasively and a waveform associated with electrical activation of the major portions of the His-Purkinje system was obtained.
D000200:Action Potentials; D000328:Adult; D001281:Atrial Fibrillation / Q000503:physiopathology; D001283:Atrioventricular Node / Q000503:physiopathology; D002036:Bundle of His / Q000503:physiopathology*; D003936:Diagnosis, Computer-Assisted; D004562:Electrocardiography / Q000295:instrumentation / Q000379:methods*; D006325:Heart Atria / Q000503:physiopathology; D006329:Heart Conduction System / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D009200:Myocardial Contraction; D011690:Purkinje Fibers / Q000503:physiopathology*; D009435:Synaptic Transmission