Giuffrida G, Critelli G, Giudice P, Miceli D, Betocchi S, Mazza F, Chiariello M, Condorelli M
J Electrocardiol. 1981;14(2):125-8. doi: 10.1016/s0022-0736(81)80046-5.
In eighteen patients with atrioventricular conduction disturbance, His bundle electrograms were studied via the arm vein. A 6F Berkovits-Castellanos USCI hexapolar electrode catheter was introduced into the right atrium and looped across the tricuspid valve in a "golf club" shape. The main aim was to leave the two distal electrodes in contact with the atrial endocardium to perform atrial pacing, while displaying the other four electrodes along the superior angle of the tricuspid valve for proximal and distal His bundle recordings. His bundle electrograms were successfully obtained in all cases. The arm approach provides an alternate route whenever the femoral approach is not feasible. Moreover, the use of an hexapolar electrode catheter provides some practical advantages: 1) it enables atrial pacing to be performed, as well as proximal and distal His bundle recording to be obtained, by using the same multipolar electrode catheter; and 2) it allows long-term monitoring of His bundle potentials, in view of the stability of His bundle recordings. Finally, the arm approach could be the method of choice for the study of His bundle electrograms during leg supine exercise in selected patients.
对18例房室传导障碍患者经臂静脉进行希氏束电图研究。将一根6F的Berkovits-Castellanos USCI六极电极导管插入右心房，并呈“高尔夫球杆”形状绕过三尖瓣。主要目的是使两个远端电极与心房内膜接触以进行心房起搏，同时沿三尖瓣上角展示另外四个电极以记录希氏束近端和远端电活动。所有病例均成功获得希氏束电图。当股静脉途径不可行时，臂静脉途径提供了另一种选择。此外，使用六极电极导管具有一些实际优势：1）通过使用同一多极电极导管，既能够进行心房起搏，又能够获得希氏束近端和远端电活动记录；2）鉴于希氏束电图记录的稳定性，可对希氏束电位进行长期监测。最后，对于选定患者在腿部仰卧位运动期间进行希氏束电图研究时，臂静脉途径可能是首选方法。
