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ARTICLE |

Diagnostic Evaluation of Arrhythmic Disorders: Title and subTitle BreakClinical Application of His Bundle Electrography FREE

Kenneth M. Rosen, MD; Ramesh G. Dhingra, MD; Pablo Denes, MD
[+] Author Affiliations

Reprint requests to Cardiology Section, University of Illinois Hospital PO Box 6998, Chicago, IL 60680 (Dr. Rosen).


JAMA. 1974;229(1):63-64. doi:10.1001/jama.1974.03230390039022
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THE specialized cardiac conduction system consists of sinus node, atrioventricular node, His bundle, and the bundle-branch system. Impulse formation is normally initiated in the sinus node, while the other structures are necessary for conduction of the impulse from atrium to ventricles and for distribution of the impulse in an orderly fashion to the ventricles. Activation of the specialized conduction system is not seen directly on the surface electrocardiogram, which only shows activity of atrial muscle (P wave) and ventricular muscle (QRS complex). Abnormalities of the specialized conduction system are inferred from the surface cardiogram; eg, atrioventricular block, which produces abnormal conduction patterns between P waves and QRS complexes, and bundle-branch blocks, which produces a disordered QRS.

Techniques are now available that allow a more direct look at the function of the specialized conduction system.1-4 The most important of these is the catheter recording of His bundle electrograms. With catheterization of

REFERENCES

Rosen KM:  Evaluation of cardiac conduction in the cardiac catheterization laboratory . Am J Cardiol 30:701-703, 1972;.
Rosen KM:  Catheter recording of His bundle electrograms . Mod Concepts Cardiovasc Dis 42:23-28, 1973;.
Damato AN, Gallagher JJ, Lau SH:  Application of His bundle recordings in diagnosing conduction disorders . Prog Cardiovasc Dis 14:601-620, 1972;.
Narula OS, et al:  Atrioventricular block: Localization and classification by His bundle recordings . Am J Med 50:146, 1971;.
Dhingra RC, et al:  The natural history of second degree A-V block and bundle-branch block: Observations regarding site and type of block . Circulation , to be published.
Rosen KM:  Site and type of second degree A-V block . Chest 61:99-100, 1972;.
Rosen KM, et al:  Chronic heart block in adults. Clinical and electrophysiological observations . Arch Intern Med 131:663-672, 1973;.
Ferrer MI:  The sick sinus syndrome . Circulation 47:635-641, 1973;.
Goldreyer BN, Damato AN:  The essential role of atrioventricular conduction delay in the initiation of paroxysmal supraventricular tachycardia . Circulation 43:679-687, 1971;.
Durrer D, Schuilenburg RM, Wellens HJJ:  Preexcitation revisited . Am J Cardiol 25:690-697, 1970;.
Gilbert M, Wallace A, Sealy WC:  Management of the preexcitation syndrome, abstracted . Circulation 48( (suppl 4) ):17, 1973;.

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Rosen KM:  Evaluation of cardiac conduction in the cardiac catheterization laboratory . Am J Cardiol 30:701-703, 1972;.
Rosen KM:  Catheter recording of His bundle electrograms . Mod Concepts Cardiovasc Dis 42:23-28, 1973;.
Damato AN, Gallagher JJ, Lau SH:  Application of His bundle recordings in diagnosing conduction disorders . Prog Cardiovasc Dis 14:601-620, 1972;.
Narula OS, et al:  Atrioventricular block: Localization and classification by His bundle recordings . Am J Med 50:146, 1971;.
Dhingra RC, et al:  The natural history of second degree A-V block and bundle-branch block: Observations regarding site and type of block . Circulation , to be published.
Rosen KM:  Site and type of second degree A-V block . Chest 61:99-100, 1972;.
Rosen KM, et al:  Chronic heart block in adults. Clinical and electrophysiological observations . Arch Intern Med 131:663-672, 1973;.
Ferrer MI:  The sick sinus syndrome . Circulation 47:635-641, 1973;.
Goldreyer BN, Damato AN:  The essential role of atrioventricular conduction delay in the initiation of paroxysmal supraventricular tachycardia . Circulation 43:679-687, 1971;.
Durrer D, Schuilenburg RM, Wellens HJJ:  Preexcitation revisited . Am J Cardiol 25:690-697, 1970;.
Gilbert M, Wallace A, Sealy WC:  Management of the preexcitation syndrome, abstracted . Circulation 48( (suppl 4) ):17, 1973;.
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