Hydrogen and Ascorbate Dilution Curves

A simplified Method for Routine Use in Detection of Intracardic Shunt and Valvular Regurgitation

¹ Associate Professor of Medicine, The George Washington University School of Medicine; Chief of Cardiology, District of Columbia General Hospital

A dual platinum electrode system for recording hydrogen and ascorbate dilution curves has simplified the once-complicated technique to such an extent that it may be used during routine cardiac catheterization for detection of intracardiac shunts and valvular regurgitation. It comprises two flexible platinum probes: one inserted in a peripheral artery and the other placed transvenously either distal to the site of a left-to-right shunt for hydrogen dilution curves or proximal to the site of a right-to-left shunt or to an incompetent cardiac valve for ascorbate dilution curves. No expensive equipment is involved, and no modification of the routine procedure in a cardiac catheterization laboratory is necessary. Demonstration and localization of shunt and valvular regurgitation can be carried out easily, quickly, reliably and safely with the same dual-electrode system. Neither blood withdrawal which all other in vitro indicator dilution studies necessitate nor potential hazard to the patient which selective angiocardiography may carry is involved. Its routine use during diagnostic cardiac catheterization has been rewarded by detection of unsuspected complicating lesions and resolution of difficult diagnostic problems. Among added advantages of using a platinum electrode during cardiac catheterization are intracardiac electrography for diagnosis of complex arrhythmias and temporary endocardiac pacing for both diagnostic and therapeutic purposes.

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