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In vivo recording of Zhang’s phenomenon (His electrogram alternans): a novel index of atrioventricular node dual pathway conduction

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Abstract

Background

Zhang’s phenomenon (originally His electrogram alternans) is a new index of atrioventricular node dual pathway electrophysiology. This index has been described and validated in isolated hearts in vitro, but has not been recorded in vivo.

Methods

This study explored the feasibility of in vivo recording of Zhang’s phenomenon (His electrogram alternans) in six dogs with a custom-built bipolar electrode.

Results

The His electrogram recorded from superior His bundle domain (superior His electrogram) was high in amplitude at basic beats and long coupling intervals (i.e., fast pathway conduction) and low amplitude at short prematurities (i.e., slow pathway conduction). In contrast, His electrogram recorded from the inferior His bundle domain (inferior His electrogram) was always from low amplitude during fast pathway conduction to high amplitude during slow pathway conduction. The characteristic His electrogram alternans had been recorded in vivo in all six animals.

Conclusions

This study provided the first data representing in vivo recording of Zhang’s phenomenon (His electrogram alternans) in large animals. Clinical studies are needed before this novel index can be applied in patients.

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Authors and Affiliations

  1. Departments of Cardiovascular Medicine and Molecular Cardiology, The Cleveland Clinic Foundation, Cleveland, OH, USA

    Youhua Zhang

  2. Department of Biomedical Sciences, New York Institute of Technology College of Osteopathic Medicine, Room 211, Rockefeller Building, Northern Boulevard, P.O. box 8000, Old Westbury, NY, 11568, USA

    Youhua Zhang

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  1. Youhua Zhang
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Correspondence to Youhua Zhang.

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Zhang, Y. In vivo recording of Zhang’s phenomenon (His electrogram alternans): a novel index of atrioventricular node dual pathway conduction. J Interv Card Electrophysiol 40, 99–103 (2014). https://doi.org/10.1007/s10840-014-9905-z

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  • DOI: https://doi.org/10.1007/s10840-014-9905-z

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