Electrocardiogram: his bundle potentials can be recorded noninvasively beat by beat on surface electrocardiogram

BACKGROUND: The micro waveform of His bundle potential can’t be recorded beat-to-beat on surface electrocardiogram yet. We have found that the micro-wavelets before QRS complex may be related to atrioventricular conduction system potentials. This study is to explore the possibility of His bundle potential can be noninvasively recorded on surface electrocardiogram. METHODS: We randomized 65 patients undergoing radiofrequency catheter ablation of paroxysmal superventricular tachycardia (exclude overt Wolff-Parkinson-White syndrome) to receive “conventional electrocardiogram” and “new electrocardiogram” before the procedure. His bundle electrogram was collected during the procedure. Comparative analysis of PA(s) (PA interval recorded on surface electrocardiogram), AH(s) (AH interval recorded on surface electrocardiogram) and HV(s) (HV interval recorded on surface electrocardiogram) interval recorded on surface “new electrocardiogram” and PA, AH, HV interval recorded on His bundle electrogram was investigated. RESULTS: There was no difference (P > 0.05) between groups in HV(s) interval (49.63 ± 6.19 ms) and HV interval (49.35 ± 6.49 ms). Results of correlational analysis found that HV(S) interval was significantly positively associated with HV interval (r = 0.929; P < 0.01). CONCLUSIONS: His bundle potentials can be noninvasively recorded on surface electrocardiogram. Noninvasive His bundle potential tracing might represent a new method for locating the site of atrioventricular block and identifying the origin of a wide QRS complex.