Abstract
To determine right ventricular (RV) endocardial activation (surface ECG to fast deflection of intracardiac electrogram) we measured activation of (a) right ventricular apex (RVA) (N=34), (b) right ventricular outflow (RVO) (N=6) and (c) right ventricular inflow (RVI) (N=3) using closely spaced (2mm) bipolar electrode catheter. Catheter positions were verified by biplane fluoroscopy with a C-arm rotated in the horizontal plane. Median age of children studied was 10 yrs (range 0.5-20.8). None had right bundle branch block (RBBB) on surface ECG. Using frequency band pass (15-300 Hz) RVA was 25.9±8.2 msec (10-42) and did not correlate with either age or RV pressure. RVI was 44.7±9.8 msec (39-56) and was 68% longer than RVA. RVO was 50.7±11.0 msec (33-66) and was 89% longer than RVA. The influence of high (150-1000 Hz) and low (15-300 Hz) filters on RVA was evaluated in 13 of these patients and 6 others with RBBB. RVA at high frequency band was on the average 1.2 msec shorter than and correlated well (r=.96) with RVA at the low frequency range.
We conclude that RV endocardial activation, measured at cardiad catheterization, proceeds in the expected manner and time course, with no clinically important difference between RVA recorded at high and low frequencies. Thus the method may be useful in defining RV endocardial activation disturbances prior to and after intracardiac surgery for congenital heart disease.
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Dick, M., Hougen, T. & Rosenthal, A. 98 RIGHT VENTRICULAR ENDOCARDIAL ACTIVATION MEASURED BY CATHETER TECHNIQUE: VALUES IN CHILDREN AND INFLUENCE OF HIGH AND LOW FILTERS. Pediatr Res 12 (Suppl 4), 380 (1978). https://doi.org/10.1203/00006450-197804001-00103
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DOI: https://doi.org/10.1203/00006450-197804001-00103