{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T21:35:16Z","timestamp":1774647316455,"version":"3.50.1"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2001,8,14]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:italic>\n                  <jats:bold>Background<\/jats:bold>\n                <\/jats:italic>\n              <\/jats:italic>\n            <\/jats:bold>\n            His electrogram (HE) amplitude and morphology changes were observed in our previous studies during transition from \u201cfast\u201d to \u201cslow\u201d atrioventricular nodal (AVN) conduction. This phenomenon and its significance for the dual-AVN electrophysiology are not well recognized and have not been studied.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:italic>\n                  <jats:bold>Methods and Results<\/jats:bold>\n                <\/jats:italic>\n              <\/jats:italic>\n            <\/jats:bold>\n            Experiments were performed on 17 healthy rabbit atrial-AVN preparations during standard programmed electrical pacing. HEs were mapped along the His bundle with roving surface electrodes, along with recording of cellular action potentials (APs). HEs recorded from the superior margin of the His bundle were of greater amplitude during basic beats and decreased substantially, by 42\u00b119% (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.01), when premature A\n            <jats:sub>1<\/jats:sub>\n            A\n            <jats:sub>2<\/jats:sub>\n            shortened to 178\u00b120 ms. In contrast, the HEs from the inferior margin increased dramatically, 2.9\u00b11.7 times (\n            <jats:italic>P<\/jats:italic>\n            &lt;0.01), during short A\n            <jats:sub>1<\/jats:sub>\n            A\n            <jats:sub>2<\/jats:sub>\n            and remained high until AVN block occurred. In addition, during long A\n            <jats:sub>1<\/jats:sub>\n            A\n            <jats:sub>2<\/jats:sub>\n            , the superior HEs consistently preceded the inferior by 1.9\u00b10.7 ms. In contrast, at short A\n            <jats:sub>1<\/jats:sub>\n            A\n            <jats:sub>2<\/jats:sub>\n            , the superior HEs occurred 2.7\u00b10.8 ms after the inferior. Cellular AP recordings demonstrated clearly the presence of and the transition between early (fast) and late (slow) excitation wavefronts that accompanied HE alternans.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>\n                <jats:italic>\n                  <jats:bold>Conclusions<\/jats:bold>\n                <\/jats:italic>\n              <\/jats:italic>\n            <\/jats:bold>\n            The morphological-electrophysiological evidence from the AV junction suggests that fast and slow wavefronts reach the His bundle differently, producing functional longitudinal dissociation into 2 domains. The characteristic HE alternans recorded from these domains are a new sensitive tool to determine the presence of distinctly different wavefronts and their participation in the conduction during reentrant or other arrhythmias. These findings provide further understanding of the mechanisms of dual-AVN electrophysiology.\n          <\/jats:p>","DOI":"10.1161\/hc3301.092804","type":"journal-article","created":{"date-parts":[[2007,9,28]],"date-time":"2007-09-28T18:31:09Z","timestamp":1191004269000},"page":"832-838","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["His Electrogram Alternans Reveal Dual-Wavefront Inputs Into and Longitudinal Dissociation Within the Bundle of His"],"prefix":"10.1161","volume":"104","author":[{"given":"Youhua","family":"Zhang","sequence":"first","affiliation":[{"name":"From the Department of Cardiology, the Cleveland Clinic Foundation, Cleveland, Ohio, and Maurice Lev Congenital Heart and Conduction System Center, the Heart Institute for Children, Hope Children\u2019s Hospital, Oak Lawn, Ill, and University of Illinois, Chicago (S.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saroja","family":"Bharati","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, the Cleveland Clinic Foundation, Cleveland, Ohio, and Maurice Lev Congenital Heart and Conduction System Center, the Heart Institute for Children, Hope Children\u2019s Hospital, Oak Lawn, Ill, and University of Illinois, Chicago (S.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kent A.","family":"Mowrey","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, the Cleveland Clinic Foundation, Cleveland, Ohio, and Maurice Lev Congenital Heart and Conduction System Center, the Heart Institute for Children, Hope Children\u2019s Hospital, Oak Lawn, Ill, and University of Illinois, Chicago (S.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaowei","family":"Zhuang","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, the Cleveland Clinic Foundation, Cleveland, Ohio, and Maurice Lev Congenital Heart and Conduction System Center, the Heart Institute for Children, Hope Children\u2019s Hospital, Oak Lawn, Ill, and University of Illinois, Chicago (S.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick J.","family":"Tchou","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, the Cleveland Clinic Foundation, Cleveland, Ohio, and Maurice Lev Congenital Heart and Conduction System Center, the Heart Institute for Children, Hope Children\u2019s Hospital, Oak Lawn, Ill, and University of Illinois, Chicago (S.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Todor N.","family":"Mazgalev","sequence":"additional","affiliation":[{"name":"From the Department of Cardiology, the Cleveland Clinic Foundation, Cleveland, Ohio, and Maurice Lev Congenital Heart and Conduction System Center, the Heart Institute for Children, Hope Children\u2019s Hospital, Oak Lawn, Ill, and University of Illinois, Chicago (S.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.19.2.378"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1995.tb00414.x"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.57.3.624157"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.56.6.923070"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.101.17.2110"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0008-6363(99)00201-1"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.102.23.2856"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.98.2.164"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.99.17.2323"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1997.tb00999.x"},{"key":"e_1_3_2_11_2","unstructured":"Lev M Bharati S. Lesions of the conduction system and their functional significance.In: Sommers SC ed. Pathology Annual. New York NY: Appleton-Century Crofts; 1974: 157\u2013208."},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1161\/res.35.6.909"},{"key":"e_1_3_2_13_2","unstructured":"Tawara S. Das Reizleitungssystem des Saugetierherzens: eine anatomisch-histologische Studie \u00fcber das Atrioventrikularb\u00fcndel und die purkinjeschen F\u00e4den. Jena Germany: Gustav Fischer; 1906:9\u201370 114\u2013156."},{"key":"e_1_3_2_14_2","unstructured":"Bharati S. Anatomic-morphologic relation between AV nodal structure and function in the normal and diseased heart.In: Mazgalev TN Tchou PJ eds. Atrial-AV Nodal Electrophysiology: A View From the Millennium. Armonk NY: Futura Publishing Co; 2000: 25\u201348."},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1998.tb00927.x"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.1995.tb00754.x"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.101.9.1049"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/res.32.4.509"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-0736(78)80140-X"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2000.tb00733.x"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/hc3301.092804","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,14]],"date-time":"2024-05-14T01:45:41Z","timestamp":1715651141000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/hc3301.092804"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,8,14]]},"references-count":20,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2001,8,14]]}},"alternative-id":["10.1161\/hc3301.092804"],"URL":"https:\/\/doi.org\/10.1161\/hc3301.092804","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,8,14]]},"assertion":[{"value":"2001-08-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}