title: Are double potentials markers of a specific zone of the atrioventricular junction in the isolated rabbit heart?
abstract: A study is made of the characteristics of the atrial potentials recorded in the Koch triangle and its proximity, their variations on modifying the site of cardiac pacing, and their usefulness as markers of a distinct zone of the AV junction. In 12 isolated and perfused rabbit heart preparations an analysis was made of the endocardial atrial electrograms recorded with a multiple electrode positioned in the AV junction. The electrograms were obtained during spontaneous rhythm and on pacing at the crista terminalis (CT), interatrial septum (IAS), left atrium, and right ventricle. Double potentials were frequently obtained. On pacing at the CT, high-low double potentials (DP [H-L]) were more frequent (P < 0.05) in the low CT (11% +/- 4% of the electrodes) and posterior zone of the Koch triangle (6% +/- 5%), than in the IAS (1% +/- 2%) and anterior zone of the Koch triangle (2% +/- 3%). A similar tendency was observed either on pacing at the left atrium or during spontaneous rhythm. During pacing at the IAS the percentages of low-high double potentials (DP (L-H]) were significantly higher (P < 0.05) in the low CT (7% +/- 6%). DP (H-L) were of low sensitivity in indicating a given zone; maximum sensitivity was 61% in the low CT when pacing at the CT. DP (L-H) proved even less sensitive in indicating a given zone, though their specificity was greater in the low CT (91%) during pacing at the IAS. The specific zones in which the highest percentages of DP (H-L) or DP (L-H) are obtained depend on the site of cardiac pacing. On pacing at the IAS, DP (L-H) are more specific of the low CT. During pacing at both the CT and at the IAS, DP (H-L) sensitivity in indicating a given zone is low.
authors.affiliation: Service of Cardiology, Valencia University Clinic Hospital, Spain.
authors.forename: F J
authors.initials: FJ
authors.lastname: Chorro
authors.forename: J
authors.initials: J
authors.lastname: Sanchis
authors.forename: L
authors.initials: L
authors.lastname: Such
authors.forename: R
authors.initials: R
authors.lastname: García-Civera
authors.forename: E
authors.initials: E
authors.lastname: Llavador
authors.forename: J J
authors.initials: JJ
authors.lastname: Llavador
authors.forename: J V
authors.initials: JV
authors.lastname: Monmeneu
authors.forename: V
authors.initials: V
authors.lastname: López-Merino
mesh_terms: D000200:Action Potentials; D000818:Animals; D016275:Atrial Function; D001283:Atrioventricular Node / Q000503:physiopathology*; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D006339:Heart Rate; D066298:In Vitro Techniques; D011817:Rabbits; D012680:Sensitivity and Specificity; D016276:Ventricular Function