A study of methods for surgical interruption of the His bundle.

The relationship of the atrioventricular (AV) node and His bundle to surrounding structures is described from the viewpoint of the surgeon. A series of experiments were carried out for interruption of atrial to ventricular conduction that included electrocauterization of the His bundle, incision just above the tricuspid annulus to attempt to divide the His bundle, and finally excision of the right atrial wall and the insertion of the atrial septum into the right fibrous trigone to remove all connections from the AV node and atrium to the His bundle. The last procedure was the most satisfactory method, as judged by the certainty of accomplishing both His bundle interruption and interruption at its highest possible point.