[Noninvasive registration of His bundle potentials with temporal and spatial averaging].

On the body surface of ten people with healthy hearts, His bundle signals were measured using a high-resolution IBM-PC-controlled, 64-channel ECG unit. From these, body surface potential maps (BSPM) were recorded in the PQ-segment. Separation from the disturbance-causing atrium potentials was carried out using two methods: the difference method and the differentiation method. The His maps formed the basis for improvement of the measuring method of non-invasive, beat-to-beat recording of the His bundle potentials. Different combinations and electrode placements for measurements of the His signal were tested using the beat-to-beat method. It was found that both unipolar, as well as bipolar measurements yield good results. Two of the unipolar and two of the bipolar electrode arrangements were included on our short list, one of which is particularly recommended for clinical application. In the case of unipolar measurements, the best combination is that with eight electrodes on the chest, whose sum-potential is measured using CTP as reference. The PQ-times and the HV intervals were stable in the ten healthy people tested, so that we were able to carry out time averaging in addition. For practical clinical purposes, we recommend the unipolar beat-to-beat measurement method for non-invasive His electrocardiography. The bipolar method only yields better results in the presence of weak His signals.