Real-time beat-to-beat measurement of conduction intervals during cardiac electrophysiological studies

The conduction times through different myocardial structures have been measured in real-time during clinical intracardiac investigations by means of a low-cost microprocessor-based system. Two endocavitary electrograms, a surface ECG and a pacemaker stimulus are analysed to detect the stimulus as well as atrial, His and ventricular waves and to measure, beat to beat, the time intervals between them. Measurements have been made in the course of 40 clinical studies, randomly chosen from about 500, and including different conditions such as sinus rhythm, acute drug tests and programmed atrial pacing. Our results show that the real-time measurement of the conduction intervals is feasible and may offer several advantages: it allows immediate data analysis which enables the investigator to better make decisions during the study; it reduces the time and effort required to perform and analyse the study; and it increases the quantity and quality of information gained on the cardiac status of the patient.