Williams D O, Scherlag B J, Hope R R, El-Sherif N, Lazzara R, Samet P
Cardiovasc Res. 1976 Jan;10(1):91-100. doi: 10.1093/cvr/10.1.91.
His bundle pacing was achieved in 10 anaesthetized open chest dogs by stimulation from bipolar electrode catheters positioned in the aortic root and right heart. Recordings were taken directly through plunge wires from the right atrium, high ventricular septum, and epicardial sites on the right and left ventricles. Six types of response were seen during A-V junctional stimulation: (1) low atrial pacing; (2) combined atrial and His bundle pacing; (3) His bundle pacing; (4) combined atrial, ventricular septal, and His bundle pacing; (5) combined septal and His bundle pacing; and (6) ventricular pacing. Pacing of the His bundle in combination with the atrium and/or ventricular septum is designated as non-selective, whereas stimulation of the His bundle alone is considered selective pacing. Non-selective His bundle pacing can be recognized from the surface leads by changes in onset and amplitude of the QRS with appreciable T-wave alterations. Although electrode position was an important determinant of the type of pacing achieved, a variety of patterns of stimulation resulted from variation in the modalities of the pacing stimulus, ie, polarity, intensity, and duration. Unless these factors are considered, selective His bundle pacing may not be achieved.
通过置于主动脉根部和右心的双极电极导管刺激，在10只麻醉开胸犬中实现了希氏束起搏。通过插入线直接从右心房、高位室间隔以及左右心室的心外膜部位进行记录。在房室交界区刺激期间观察到六种反应类型：(1)低位心房起搏；(2)心房和希氏束联合起搏；(3)希氏束起搏；(4)心房、室间隔和希氏束联合起搏；(5)室间隔和希氏束联合起搏；(6)心室起搏。希氏束与心房和/或室间隔联合起搏被称为非选择性起搏，而单独刺激希氏束被认为是选择性起搏。非选择性希氏束起搏可通过体表导联上QRS波起始和幅度的变化以及明显的T波改变来识别。尽管电极位置是实现起搏类型的重要决定因素，但起搏刺激方式（即极性、强度和持续时间）的变化会导致多种刺激模式。除非考虑这些因素，否则可能无法实现选择性希氏束起搏。
