On-line interval measurement during invasive cardiac electrophysiologic testing

Improved beat-to-beat timing measurements of His-bundle signal

A simplified bioelectric model of the atrioventricular (AV) junction is proposed to better understand the underlying biophysical generation of intracardiac His-bundle signal and to analyze the effects of electrocatheter displacements on waveform morphology and estimation of AV node conduction time (AVCT). Based on this model, an inverse problem approach has been developed to estimate electrode displacements occurring in real recordings. A measurement correction method is proposed to improve estimation of AVCT. Results illustrate autonomic influences on AVCT, a phenomenon hardly measured with common techniques.

Real-time, automated, interactive cardiac electrophysiology testing

We describe a new automated interactive system that performs all of the functions required for complete evaluation of the intracardiac conduction system, for inducing, terminating and analyzing tachydysrhythmias, and for locating and characterizing accessory atrioventricular (AV) connections and ectopic foci. In the first year of operation, the system was used to conduct 210 electrophysiology studies. These ranged from simple postoperative evaluation of the conduction system to complete tachycardia studies during pharmacological manipulation of the patient. Patient age at time of catheterization ranged from 6 days to 70 years, with median age of 8 years and 7 months. Advantages accruing from automated electrophysiology testing with this system included great precision and accuracy of timing measurements, flexibility in designing and implementing pacing protocols, and rapid management of induced or spontaneous dysrhythmias. Significant savings of time and labor were achieved by computer generation of reports and graphs as opposed to manual data extraction and plotting. The single most significant advantage is the ability of the system to provide information on a real-time basis, permitting the electrophysiologist to analyze, modify, extend or curtail the procedure.