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April 1, 2026Open Access

Electrophysiologic Studies on Various Conducting Accessory Pathways in Ventricular Pre-excitations Using Recording Technique of His Bundle Electrograrns.

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Why the study?

Does His bundle electrography combined with rapid atrial pacing elucidate the mechanisms of accessory pathways in patients with ventricular pre-excitation?

Population

2 control subjects and 4 cases with ventricular pre-excitation

Comparison

Ventricular pre-excitation group vs non-ventricular pre-excitation control group

Key result

Rapid atrial pacing combined with His bundle electrocardiography demonstrated that ventricular pre-excitation occurs through both normal conduction systems and accessory pathways.

Authors

SKSugiki Kenji

Discussion

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Overview

May facilitate accurate diagnosis of pre-excitation mechanisms; extends application of His bundle electrocardiography with rapid atrial pacing.

Key Points

  • This study aims to analyze electrophysiological properties of various accessory pathways in ventricular pre-excitation using His bundle electrograms.
  • Examined non-ventricular pre-excitation and ventricular pre-excitation groups using His bundle electrograms.
  • Utilized artificial rapid atrial pacing up to 500 beats/min to assess conduction.
  • Monitored the response of the conduction system to varying pacing rates, with focus on anomalies.
  • Ventricular pre-excitation group showed mechanisms similar to W-P-W syndrome with conduction disturbances.
  • At high pacing rates, normal conduction systems displayed increased conduction times and Wenckebach periods.
  • Different mechanisms of conduction disturbances were identified, including infra-Hisian and supra-Hisian pathways.

Study Design

Type

Observational (n=26)

Structured PICO

Does His bundle electrography combined with rapid atrial pacing elucidate the mechanisms of accessory pathways in patients with ventricular pre-excitation?

P
Population
Patients with suspected or confirmed congenital/acquired heart diseases or various arrhythmias, including 22 without ventricular pre-excitation and 4 with ventricular pre-excitation (WPW or LGL syndrome).
I
Intervention
His bundle electrogram recording combined with artificial rapid atrial pacing
C
Comparator
null
O
Outcome
Electrophysiological properties of the specialized conduction system and accessory pathwayssurrogate

His bundle electrography with rapid atrial pacing is a valuable diagnostic tool for uncovering latent AV conduction defects and differentiating the mechanisms of ventricular pre-excitation syndromes.

Limitations

  • Difficulty in obtaining His bundle electrograms in cases with intermittent occurrences of tachycardial attacks.
  • Selection of extremely small time constants resulted in marked decrease in voltage of His bundle activities.

Cite This Study

Sugiki Kenji (1973) conducted an observational in Ventricular pre-excitation syndrome and various arrhythmias (n=26). His bundle electrogram recording and atrial pacing was evaluated on Electrophysiologic properties (A-H and H-V intervals) during atrial pacing. Rapid atrial pacing combined with His bundle electrocardiography demonstrated that ventricular pre-excitation occurs through both normal conduction systems and accessory pathways.

synapsesocial.com/papers/69cd7af55652765b073a8994https://doi.org/10.15114/smj.42.317
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