What is the clinical evidence from this study?

Study design: Observational. Population: Patients undergoing electrophysiological evaluation (n=30). Intervention: Pervenous His bundle and A-V node pacing. Primary outcome: Conduction times and QRS complex morphology.

What question did this study set out to answer?

To evaluate the feasibility and electrophysiological characteristics of pervenous catheter pacing of the His bundle and atrioventricular junction in humans.

January 1, 1970CirculationOpen Access

Pervenous Pacing of the Specialized Conducting System in Man

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Key result

Pervenous His bundle and A-V node pacing was successfully achieved in 30 patients, maintaining an unchanged QRS complex and proving useful for diagnosing bilateral bundle-branch block.

Why the study?

Does pervenous pacing of the His bundle and A-V node alter conduction times and QRS morphology compared to normal sinus rhythm in human patients?

Population

n=30 patients undergoing pervenous electrode catheterization for His bundle electrogram recording and A-V…

Comparison

Pervenous pacing of the specialized conducting… vs Normal sinus rhythm.

Design

Case_series

Authors

ONOnkar S. NarulaUniversity of Miami BSBenjamin J. ScherlagElectrophysiology PSPhilip SametBaptist Hospital of Miami

Discussion

Member takes

Implication

May support targeted diagnosis of conduction blocks in select cases; leaves open routine adoption pending prospective validation.

Key Points

To evaluate the feasibility and electrophysiological characteristics of pervenous catheter pacing of the His bundle and atrioventricular junction in humans.
Conducted pervenous electrode catheterization in 30 patients to record His bundle electrograms and deliver junctional pacing.
Measured atrium-to-His bundle (A-H) and His-to-ventricle (H-V) conduction times, alongside pacing impulse-to-ventricle activation (PI-R) intervals at varying pacing rates.
Achieved successful His bundle pacing in 26 patients and atrioventricular node pacing in five patients.
His bundle pacing maintained a PI-R interval equal to intrinsic H-V conduction time across multiple pacing rates, keeping the QRS complex identical to normal sinus rhythm.
Demonstrated retrograde Wenckebach conduction during His bundle stimulation and restored effective rhythm in a patient with complete intra-His heart block.

Study Design

Type

Observational (n=30)

Structured PICO

Does pervenous pacing of the His bundle and A-V node alter conduction times and QRS morphology compared to normal sinus rhythm in human patients?

Population

n=30 patients undergoing pervenous electrode catheterization for His bundle electrogram recording and A-V junction pacing, including patients with complete heart block, right bundle-branch block, left axis deviation, and infarction.

Intervention

Pervenous pacing of the specialized conducting system (His bundle pacing in 26 patients, A-V node pacing in 5 patients) via electrode catheter.

Comparator

Normal sinus rhythm (within-patient comparison of conduction times and QRS morphology).

Outcome

Conduction times (A-H time, H-V time, PI-R interval) and QRS complex morphology.surrogate

Pervenous His bundle pacing preserves normal ventricular activation times and QRS morphology, proving useful for validating His bundle electrograms and diagnosing complex conduction blocks.

Cite This Study

Narula et al. (1970) conducted an observational in Patients undergoing electrophysiological evaluation (n=30). Pervenous His bundle and A-V node pacing was evaluated on Conduction times and QRS complex morphology. Pervenous His bundle and A-V node pacing was successfully achieved in 30 patients, maintaining an unchanged QRS complex and proving useful for diagnosing bilateral bundle-branch block.

synapsesocial.com/papers/6a0ece45aa1655e5fb22d301 https://doi.org/10.1161/01.cir.41.1.77

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January 1, 1970CirculationOpen Access

Pervenous Pacing of the Specialized Conducting System in Man

View Full Paper

Ask AI

Bookmark

Key result

Pervenous His bundle and A-V node pacing was successfully achieved in 30 patients, maintaining an unchanged QRS complex and proving useful for diagnosing bilateral bundle-branch block.

Why the study?

Does pervenous pacing of the His bundle and A-V node alter conduction times and QRS morphology compared to normal sinus rhythm in human patients?

Population

n=30 patients undergoing pervenous electrode catheterization for His bundle electrogram recording and A-V…

Comparison

Pervenous pacing of the specialized conducting… vs Normal sinus rhythm.

Design

Case_series

Authors

ONOnkar S. NarulaUniversity of Miami BSBenjamin J. ScherlagElectrophysiology PSPhilip SametBaptist Hospital of Miami

Discussion

Member takes

Implication

May support targeted diagnosis of conduction blocks in select cases; leaves open routine adoption pending prospective validation.

Key Points

To evaluate the feasibility and electrophysiological characteristics of pervenous catheter pacing of the His bundle and atrioventricular junction in humans.
Conducted pervenous electrode catheterization in 30 patients to record His bundle electrograms and deliver junctional pacing.
Measured atrium-to-His bundle (A-H) and His-to-ventricle (H-V) conduction times, alongside pacing impulse-to-ventricle activation (PI-R) intervals at varying pacing rates.
Achieved successful His bundle pacing in 26 patients and atrioventricular node pacing in five patients.
His bundle pacing maintained a PI-R interval equal to intrinsic H-V conduction time across multiple pacing rates, keeping the QRS complex identical to normal sinus rhythm.
Demonstrated retrograde Wenckebach conduction during His bundle stimulation and restored effective rhythm in a patient with complete intra-His heart block.

Study Design

Type

Observational (n=30)

Structured PICO

Does pervenous pacing of the His bundle and A-V node alter conduction times and QRS morphology compared to normal sinus rhythm in human patients?

Population

Intervention

Pervenous pacing of the specialized conducting system (His bundle pacing in 26 patients, A-V node pacing in 5 patients) via electrode catheter.

Comparator

Normal sinus rhythm (within-patient comparison of conduction times and QRS morphology).

Outcome

Conduction times (A-H time, H-V time, PI-R interval) and QRS complex morphology.surrogate

Pervenous His bundle pacing preserves normal ventricular activation times and QRS morphology, proving useful for validating His bundle electrograms and diagnosing complex conduction blocks.

Cite This Study

synapsesocial.com/papers/6a0ece45aa1655e5fb22d301 https://doi.org/10.1161/01.cir.41.1.77

Also Consider

Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context:

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