His bundle pacing utilizes the His-Purkinje system to produce more physiological activation compared to traditional pacing therapies, but differences in electrical activation between pacing techniques are not yet quantified in terms of activation pattern. Furthermore, clinicians distinguish between selective and non-selective His pacing, but measurable differences in electrical activation remain to be seen. Hearts isolated from 7 dogs were perfused using the Langendorff method. Electrograms were recorded using two 64-electrode basket catheters in the ventricles and a 128-electrode sock situated around the ventricles during sinus rhythm (right atrial pacing), right ventricular (RV) pacing, biventricular cardiac resynchronization therapy (biV-CRT), selective His pacing (selective capture of the His bundle), and non-selective His pacing (capture of nearby myocardium and His bundle). Activation maps were generated from these electrograms. Total activation time (TAT) was measured from the activation maps and QRS duration was measured from a 1-lead pseudo ECG. Results showed that TAT, QRS duration, and activation sequence were most similar between sinus, selective, and non-selective His pacing. Bland-Altman analyses showed highest levels of similarity between all combinations of sinus, selective, and non-selective His pacing. RV and biV-CRT activation patterns were distinct from sinus and had significantly longer TAT and QRS duration. Cumulative activation graphs were most similar between sinus, selective, and non-selective His pacing. In conclusion, selective and non-selective His bundle pacing are more similar to sinus compared to RV and biV-CRT pacing. Furthermore, selective and non-selective His bundle pacing are not significantly different electrically.

中文翻译：

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他的捆绑起搏显示出与窦相似的心室电激活；选择性和非选择性他的起搏无法区分

与传统的起搏疗法相比，他的束状起搏利用 His-Purkinje 系统产生更多的生理激活，但在激活模式方面尚未量化起搏技术之间的电激活差异。此外，临床医生区分选择性和非选择性 His 起搏，但电激活的可测量差异仍有待观察。使用 Langendorff 方法灌注从 7 只狗中分离出来的心脏。在窦性心律（右心房起搏）、右心室 (RV) 起搏、双心室心脏再同步治疗 (biV-CRT)、选择性期间，使用心室中的两个 64 电极篮式导管和位于心室周围的 128 电极袜子记录电图他的步调（选择性捕获他的捆绑包），和非选择性 His 起搏（捕获附近的心肌和 His 束）。从这些电图生成激活图。从激活图测量总激活时间 (TAT)，从 1 导联伪 ECG 测量 QRS 持续时间。结果表明，窦性、选择性和非选择性 His 起搏之间的 TAT、QRS 持续时间和激活序列最相似。Bland-Altman 分析显示窦性、选择性和非选择性 His 起搏的所有组合之间的相似性最高。RV 和 biV-CRT 激活模式与窦性不同，TAT 和 QRS 持续时间明显更长。窦性、选择性和非选择性 His 起搏之间的累积激活图最为相似。综上所述，与 RV 和 biV-CRT 起搏相比，选择性和非选择性 His 束起搏更类似于窦性起搏。此外，选择性和非选择性 His 束起搏在电气上没有显着差异。