A technique for recording His bundle activity in man without fluoroscopic guidance is described. Balloon tipped triOr tetrapolar catheters were designed with pacing electrodes located at the catheter tip, and two fine sensing electrodes 4 and 5 cm behind it. The catheter tip was preformed into a "J" curve. Following percutaneous transfemoral insertion, the catheter is floated to the right ventr...

Clinical and experimental observations in which bundle branch block patterns (BBBP) in ECG leads were normalized by distal His bundle (H) pacing are reported. The clinical material includes four patients with acute right BBBP secondary to anterior wall myocardial infarction and three patients with chronic left BBBP. Six of the seven patients had a prolonged H-V interval (60-85 msec) including t...

AIMS Left ventricular (LV) asynchrony assessment is mostly based on delays between regional myocardial velocity peaks. Regional function is barely considered. We propose apical transverse motion (ATM) as a new parameter integrating both temporal and functional information, which was tested in different conduction delays. METHODS AND RESULTS We examined 67 patients, 11 patients with post-infar...

The atrioventricular (AV) gap phenomenon occurs when the effective refractory period of a distal site is longer than the functional refractory period of a proximal site and when closely coupled stimuli are delayed enough at the proximal site to allow distal site recovery. According to previous studies, in type 1 gap, the distal site of block is distal to the His bundle (ventricular specialized ...

Permanent His bundle pacing (HBP) is a physiological alternative to right ventricular pacing. Acute injury to the His bundle can occur during permanent HBP in the form of transient or permanent bundle branch blocks. Observations of mechanical injury to the His bundle during HBP lead fixation and electrophysiological response to HBP provides additional mechanistic insights into the pathology of ...