Minimally invasive recording of His bundle potentials using a gastro-thoracic electrode system configuration

An important research initiative has allowed for the first time the basis of the Wellens protocol to be performed with a specially developed hexapolar gastro-oesophageal electrode (GOE) device. However, to maximize this new clinical procedure the addition of non-invasive His bundle potentials (HBP) detection will allow complete electro-physiological studies to be performed without the use of transvenous catheterisation and X-ray screening procedures. Thus, we have investigated a new method of HBP detection by using our GOE device. The novel lead configuration used here was between a high impedance chest electrode pad and the end tip electrode of the GOE device. This lead system configuration was combined with an optimized front-end ECG amplification and filtering, a high-resolution digitization at 16-bit, 4 kHz, and a particular SAECG processing technique. In a clinical trial, in four out of eight patients, successful detection of the HBP was observed. Detected HBP amplitude ranged between 1 and 3 /spl mu/V over a background noise (rms) ranging between 0.1 and 0.5 /spl mu/V as measured in the PR interval.