Puech P
Eur J Cardiol. 1978 Sep;8(2):249-60.
Endocardial electrocardiograms permit the analysis of auricular depolarization and contribute to the study of ventricular activation. Direct recording of auriculograms from the right atrium and indirect recording of the left auriculograms through the coronary sinus and pulmonary artery, show the different auricular activation pathways in common atrial flutter, atrial tachycardia and in case of retrograde atrial depolarization (via the AV node, septal or parietal accessory pathway). His bundle electrograms obtained via the femoral vein or, less easy, via the brachial vein, has introduced an essential mark in the analysis of intracardiac activation enabling us to precisely locate lesions of the AV conduction system, making easier differential diagnosis between aberrant ventricular conduction and ventricular ectopic rhythms and contributing to the study of ventricular preexcitation. Endocavitary stimulation at increasing rate and by the single extrastimulus technique is the complement of intracardiac electrocardiography in evaluating sinus node function, conduction times and refractory periods at different levels, electrophysiological properties of accessory pathways and studies of the antiarrhythmic drugs. Programmed stimulation allows the recognition of reentry as the mechanism of many tachyarrhythmias. The recording of monophasic action potential by the suction--electrode technique is another step in the intracavitary electrophysiological investigation.
心内膜心电图可用于分析心房去极化，并有助于研究心室激动。直接记录右心房的心房电图以及通过冠状窦和肺动脉间接记录左心房电图，可显示常见心房扑动、房性心动过速以及逆行心房去极化（经房室结、间隔或壁旁旁路）时不同的心房激动途径。通过股静脉获取希氏束电图，或者更困难一些通过肱静脉获取，在分析心内激动方面引入了一个重要标志，使我们能够精确地定位房室传导系统的病变，更易于鉴别心室差异传导和室性异位节律，并有助于研究心室预激。以递增速率和单次额外刺激技术进行心腔内刺激，是心内心电图在评估窦房结功能、不同水平的传导时间和不应期、旁路的电生理特性以及抗心律失常药物研究方面的补充。程控刺激可识别折返作为许多快速心律失常的机制。通过吸电极技术记录单相动作电位是心腔内电生理研究的又一步。
