Observations on the Epicardial Activation of the Normal Human Heart.
Serial hand mapping techniques in man have identified 3 to 5 sites of epicardial breakthrough (EBT). However, transmural epicardial excitation from the widely distributed His/Purkinje system suggests a more complicated pattern may exist. Multielectrode arrays used with large mapping systems during s...
| Publicado en: | Pacing & Clinical Electrophysiology Vol. 15; no. 12; pp. 2295 - 2308 |
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| Autores principales: | , |
| Formato: | Journal Article |
| Publicado: |
Wiley-Blackwell
Dec1992
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106087230&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106087230 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01478389 4F8 jtl: Pacing & Clinical Electrophysiology issn: 01478389 maglogo: Y pubinfo: dt: Dec1992 vid: 15 iid: 12 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 106087230 2009413665 NLM1282251 106087230 ppf: 2295 ppct: 13 formats: fmt: @attributes: type: P tig: atl: Observations on the Epicardial Activation of the Normal Human Heart. aug: au: Pieper CF Pacifico A sug: subj: Algorithms Electrocardiography Methods Heart Conduction System Physiology Pericardium Physiology Signal Processing, Computer Assisted Heart Conduction System Anatomy and Histology Wolff-Parkinson-White Syndrome Physiopathology Wolff-Parkinson-White Syndrome Surgery ab: Serial hand mapping techniques in man have identified 3 to 5 sites of epicardial breakthrough (EBT). However, transmural epicardial excitation from the widely distributed His/Purkinje system suggests a more complicated pattern may exist. Multielectrode arrays used with large mapping systems during surgery often present complicated and sometimes inconsistent activation patterns. The purpose of this work is to reconcile epicardial activation in the normal human heart with anatomical and endocardial/intramural physiological recordings using multichannel computer mapping requiring only a single beat, and rigorously defined arid applied activation time detection algorithms. Eighteen subjects undergoing surgery for Wolff-Parkinson-White syndrome were recorded with a 119 site sock array during nonpreexcited sinus rhythm. None had evidence of coronary artery disease and all exhibited a normal 12-lead ECG except during periods of preexcitation or tachycardia. Each was recorded bipolarly and four also were recorded monopolarly. Recordings revealed 8.0 ± 1.6 EBTs (range 5 to 12). Closely spaced, multiple EBTs often were observed and usually confirmed using different activation time detection algorithms. The earliest EBT always occurred over the anterior right ventricle at 14.3 ± 6.5 msec (range - 1 to 29 msec) after QBS onset. Subsequent EBTs could occur at any ventricular site with variable latencies. In contrast to previous reports describing epicardial spread of activation from a few foci, a mosaic of epicardial activation emerges. These data are consistent with endocardially initiated transmural activation of the epicardium suggested by the anatomy of the His/Purkinje system and intramural recordings. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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