Catheter Technique for Recording His Bundle Activity in Man

TLDR

The study presents a method for routinely recording His bundle activity in humans using a bipolar or multipolar catheter. The catheter is percutaneously inserted via the Seldinger technique through the femoral vein and advanced fluoroscopically into the right atrium. In nine patients, the technique produced stable His bundle recordings, revealed that pacing lengthened the P‑H interval while the H‑S interval remained constant, and showed that carotid sinus pressure produced similar changes, underscoring its usefulness for ECG interpretation and conduction studies.

Abstract

A technique for the routine recording of His bundle (H) activity in man using a bipolar or multipolar catheter is described. The recording catheter is inserted percutaneously, via the Seldinger method, into the right femoral vein and advanced fluoroscopically into the right atrium. Placement of the pre-formed curve at the catheter tip across the tricuspid valve in nine patients resulted in stable recordings of His bundle activity in successive cardiac cycles. Right atrial pacing resulted in progressive lengthening of the P-H interval with increasing frequency but the H to S-wave interval remained constant at all rates. Similar lengthening of the P-H interval was produced during atrial pacing when pressure was applied to the carotid sinus. The use of this recording technique in man will facilitate diagnostic interpretation of the electrocardiogram and can be used in various investigations of atrioventricular and intraventricular conduction in man.