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Resistivity of Body Tissues at Low Frequencies

By Stanley Rush, Ph.D., J. A. Abildskov, M.D., and


Richard McFee, Ph.D.

• A theoretical model capable of explaining kilos. The anesthetic was 0.5 cc./kilo of pento-
the relationship between the EMP generated bnrbital initially with additional small doses as
by the heart and the electrocardiographic needed. Observations of intact thorax and arm
resistivities were made on eight human subjects.
lead voltages must be based on quantitative The basic technique employed was that of the
knowledge of the resistivities of the tissues four-electrode measurement in which a controlled
of the thorax. At the time this study was current was introduced and removed from the
undertaken, the most recent investigations of specimen being measured by means of two 'cur-
tissue resistivity in living animals were those rent' electrodes and a resulting potential differ-
ence measured between two points on the specimen
whose results are summarized in the first with two additional 'potential' electrodes.
three columns of table I.1'2> 3 More recently, The current electrodes were connected to a cir-
the results summarized in column 4 were cuit shown in figure 1, consisting of a 540 volt
published.4 Differences in results range from battery in series with a 4 megohm resistor and a.
40% for lung to 400% for heart muscle, manually operated contact. The contact was closed
for about 0.1 seconds during the measurement
and no two groups of investigators are in thereby generating a pulse waveform at the po-
substantial agreement on all measurements. tential electrodes with approximately the same
An additional investigation of animal tis- frequency spectrum as the QRS complex.
sue resistivity is reported here and the con- A potential difference was measured on the
clusions are presented in column 5 of table 1. tissue surface by means of two needle electrodes,
each connected to an open grid of a cathode fol-
A limited attempt was made to discover the lower. The output of the cathode followers sup-
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sources of the discrepancies in previously plied the differential input of a Sanborn polyviso
published data. This was done by repeating recorder which recorded the voltage waveform on
the reported measurement procedure, by heat sensitive paper (fig. 2). The animal was
theoretical studies and by reviewing the work grounded to the electrical system at points re-
mote from the measuring electrodes.
of other investigators. Both Kaufman and Three distinct electrode arrangements were re-
Johnston, and Schwan and Kay, employed a quired for the various measurements. These will
two-electrode technique. Only the more re- be designated by the letters A, B, C, as described
cent work of the latter group was investi- in the sequel.
gated in detail. The four-electrode method was chosen primar-
ily to provide a means of eliminating the effects
The present study appears to explain satis- of contact resistance variations on the measure-
factorily the existing differences in the re- ments. Such effects were made negligible at the
ported resistivities of thoracic tissue with the potential electrodes by the very high input im-
possible exception of lung. pedance of the cathode followers and at the cur-
rent electi'odcs by use of a high voltage in series
Methods with a very high resistance as a. current source.
Measurements of specific resistance of tissue The needles used for all potential electrodes in-
were carried nut on approximately 50 live, anes- sured exact knowledge of their locations on the
thetized, mongrel dogs weighing from 14 to 30 tissue. The use of a square pulse as the measur-
ing signal permitted detection of unusual polari-
From the Department of Medicine, Upstate Medical zation or other effects which might have been
Center, and Department of Electrical Engineering, associated with measurement errors. The entire
Syracuse University, Syracuse, New York. electrode array was made small whenever this was
Supported by Research Grants H-3241 and H-3949 feasible to minimize the effects of remote tissues
from the National Heart Institute, U. S. Public on the measurements. Lastly, the same electrode
Health Service, and by grants from the Heart Asso- assemblies devised for isotropic tissues proved
ciation of Onondaga County, New York. useful for anisotropie measurements.
Received for publication July 16, 1962. Electrode set A consisted of four needles whose
Circulation Research, Volume XII, January 19GS
40
TISSUE RESISTANCE 41

TABLE 1
Mean Resistivity in Ohm-Cm
Column 1 Column 2 Column 3 Column 4 Column 5
Kaufman and ufman and Schwan and Burger and Rush, Abildskov,
Tissue Johnston van Milaan Kay van Dongen and McFee
Blood 208 160 100 160 162J
Liver 506 840 700
Heart 216 965 Pi,= 563*
P i = 252
Lung 744 1120 2100
Fat 2060 1500-5000 2500
Skeletal 648 Pi,= 470* 965 Pu— 675* P,,=2300*
muscle P . = 230 Pi = 245 Pi= 150
(hunuin or dog)
Skeletal p=1800*
muscle P i = 125
(rabbit)
Human trunk 415 463
Dog trunk 445
Torso sheath (dog) 281 +
*Pi, and Pi are high and low resistivities of nnisotropic tissue.
tData from only two subjects.
{Data taken from the literature.

points touched the tissue at four equally spaced along the lines 0 — O, 0 = n/'2 we have from
points along a straight line (fig. 3). Electrodes of equation 2
this typo are commonly used in geophysical ex-
plorations where the technique is called the Pi,
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V,
Wenner-Gish-Rooney method.5 The needles were
mounted on a small plastic bar which in turn was (3)
fixed on a V-shaped steel wire. The electrode
assembly was thus free to move in the vertical From the two expressions in equation 3, ph and p]
and horizontal directions to accommodate the can be found.
movements of the tissue being measured (fig. 5). Electrode Set B was devised to find the 'x' and
The equation from which the unknown resistiv- 'y' directions on anisotropic tissue and this in-
ity, p, of the tissue was determined is0 formation was used, in turn, to orient Set A in
accordance with equation 3. Referring to figure
V - (1) 3, it was formed by making the spacing e-h and
e-f very large and arranging electrode 'g' so that
in which 'a' is the electrode spacing, 'I' the cur- it could be placed sequentially at eight equally
rent and VBh the potential difference measured spaced points on a circle centered at V. Elec-
between electrodes 'g' and 'h'. Equation 1 applies trodes V and were mounted on a common
exactly when the electrodes are on the plane sur- spring assembly similar to that described Cor Set
face of a homogeneous, isotropic conductor of A. Electrode V pierced the center of a plastic
infinite extent which the tissue is assumed to button which had eight small holes equally spaced
approximate. around a circle of 0.5 cm radius. Electrode 'g'
For media which are anisotropic with one direc- was arranged so that it could be withdrawn from
tion 'y' of low resistivity, plt parallel to the a hole then turned and reinserted into another
bounding plane and with two high resistivity, ph, hole without disturbing the positioning of the re-
directions V and '-/,', (fig. 4) equation 1 becomes7 mainder of the electrode assembly (fig. 5).
The equation for V around a circle of radius
v _ VPI.PI I 'a' is, with the exception of a small constant
2™ V c o s - 0 + (Pi/Pn) sin-' 0 term, given by equation 3. The constant term de-
pends on the location of electrode 'h' and can be
(2) made small by locating it far from the current
0 is the angle the electrode alignment makes with electrodes. The values of V on the circle in any
the V axis. By aligning the electrodes alternately case will, if plotted on polar coordinate paper,
Circulation Research, Volume XII, January 1963
42 RUSH, ABILDSKOV, McFEE

FIGURE 1
Current circuit for four-electrode measurement.
V = 270 volts, R = 2 megohms and 'e' and 'f
represent point-electrodes through which a fixed
FIGURE 3
current passes when key is closed.
Arrangement of four point-electrodes for meas-
uring the resistivities of a semi-infinite (x > 0 an
insulator) medium.

by needles touching the specimen at points spaced


along a line parallel to the axis of the cylinder.
In measurements of the thorax of humans, cur-
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CONDUCTING/I rent was introduced through three electrodes at


MEDIUM the wrists and neck, and removed through two
electrodes at the ankles in order to obtain a uni-
form distribution in the chest. Similarly placed
electrodes were used for dog thorax measurements.
The electrodes at each end of the body were in-
terconnected with 20,000 ohm resistors to minimize
the effects of skin resistance variations on the
distribution. On human subjects, the potential
electrodes were formed by sterile hypodermic
needles spaced a measured distance apart with the
tips placed just under the skin surface and the
I
remainder insulated.
FIGURE 2
The equation for the mean resistivity of the
Potential measuring circuit. Vl = 90 volts, Vs cylindrical part being measured is
= 4") volts, Hh = 0.1 megohms and 'g' and 'h' are
potential measuring electrodes.
>= *-$-
where 'a' is the distance between potential elec-
have maximum and minimum distances from the trodes and A is the cross-sectional area of the
origin at 0 = ir/2 and 0 = 0 respectively. By cylinder. If the cylindrical part is in turn com-
relating these directions to the tissue, the informa- posed of 'm' parallel cylinders of different resistivi-
tion required to orient Set A for use with equation ties, acting as resistors in parallel, the mean re-
3 is obtained. sistivity of equation 4 is given by
Electrode Set C was employed to measure cy-
lindrical sections such as the arm and thorax. The
technique is essentially that described by Burger (5)
P
and van Milaan.2 Current was introduced and n=l "
removed from the specimen through large remote in which An is the cross-sectional area of the
electrodes and the potential electrodes were formed cylinder of tissue identified by the symbol, n, and
Circulation Research, Volume XII, January 19GS
TISSUE RESISTANCE 43

Set b

Set A

Spring
Spring

FIGURE 5
Electrode Sets A and B showing spring assemblies,
needle electrodes, plastic needle holders, and flex-
ible wire connections.
FIGURE 4
Arrangement of four point-electrodes for meas- The ratio Ysh/VKb is given by the ratio of pen
uring the resistivities of an aiiisotropic, semi- deflections, hence p can be found.
infinte (z > 0 an insulator) conducting medium.
Results
pn is the resistivity of that tissue. The total area, TISSUE MEASUREMENTS
A, is the sum of the individual tissue areas. Equa- Unless otherwise noted, tlie data for each
tion 5 is applied here to measurements on the arm tissue represents measurements on approxi-
and thorax which are assumed to consist of cy-
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mately seven animals at one to three differ-


linders of fat, bone, muscle, etc.
That the electrodes actually performed in ac- ent sites on each animal.
cordance with the theoretical predictions of equa- Liver
tion 1 was checked by using a standard solution The liver resistivity was measured using
for which the resistivity, p, was known precisely.
Tlie equation checked to a value well within the electrode Set A. The tissue was exposed by
predicted ± 5% construction tolerance of the incisions through the abdominal wall or lower
electrode array and remained constant for long ribs depending on the experiment. The result
periods of time. In addition, during the resistiv- obtained by this method was 700 olim-t-m
ity measurements, the applicability of the assump- with a per cent standard deviation oi: ± 14%.
tion of an infinite medium was evaluated for each
tissue. This was done by monitoring the thickness Comparing this with the value of S40 ohm-
of the layer being measured as well as the re- cm given by Schwan and Kay, a difference
sistivity of the underlying layer and checking of about 18% is seen to exist. By repeating
these against theoretical estimates of the effects their measurement, i.e., by measuring the re-
of these variables on the measurement. sistance with a bridge between two electrodes
In practice, the current 'I' and Vgh were not
mounted on a catheter-like holder and placed
directly measured. Instead, at various times dur-
ing an experiment, the electrode pairs e-g and in the tissue, results essentially identical with
h-f were connected to opposite terminals of a theirs were obtained.
variable standard (Shallcross No. 835 Decade Po- The difference in the results given by the
tentiometer) resistance. After adjusting the cali-
brating resistance, Rc, to give a pen deflection four-electrode and 'catheter' electrode, meas-
comparable to that produced by VRh of the medium urements is probably not significant from the
being measured, the calibrating potential differ- viewpoint of electrocardiograph}' but it is
ence V Kh is given by Ohm's Law as considered too large to be of a statistical
V'Kh = RCI (6) origin. Two possible explanations are:
which combined with equation 1 for example gives 1. Polarization Errors. The method em-
V B1 , P
ployed by Schwan and Kay may be inaccu-
(7) rate because certain unverifiable assumptions
2ml R,.
Circulation Research, Volume XII, January 196S
44 RUSH, ABILDSKOV, McFEE

were involved in deducing the corrections for ured using in sequence electrode Sets B and
polarization. Burger and van Dongen have A. The animal was placed on its right side,
given credence to this possibility by measur- artificially l'espirated and the thorax opened
ing the frequency dependence of muscle and at the fifth or sixth intercostal space. The
finding none in the range from d-c to 5,000 ribs were spread apart, the intervening por-
cycles. This is in direct contrast to the strong tion of the left lung pushed aside and the
frequency dependence for liver, muscle and pericardium opened to expose the left ven-
other tissues reported by Schwan and Kay. tricle. Electrode Set B was positioned on the
If the resistivity of liver is also frequency exposed tissue and measurements were taken
independent in this range, a higher frequency sequentially with the electrode ' g ' at the
eight indexed sites equally spaced around a
measurement with the electrodes of Schwan
circle centered at current electrode, e. The
and Kay should be more representative of
resulting curve was plotted and directions
the true situation since polarization effects
of high and low resistivity marked on the
(•an be expected to disappear as the frequency dog's skin. Electrode Set A was then aligned
is raised. Schwan and Kay measured a resis- alternately with the marked axes and read-
tivity of liver equal to that given by the four- ings taken for use with equation 3. In all
electrode method, 700 ohm-cm, in the vicinity cases, the measuring signal was superimposed
of 5,000 cycles. on the heart's electrical signal; but a large
2. Boundary Effects. The effects of insulat- number of measurements randomly spaced
ing boundaries on a resistivity measurement in time yielded a sufficient number of meas-
with a catheter electrode of the dimensions urement pulses in a relatively quiet and re-
given by Schwan and Kay3 were estimated by fractory portion of the electrical cycle for
placing the electrodes 0.5 cm from the wall readings to be taken. Additional measure-
of a glass beaker !) cm in diameter containing ments not described here, showed that the
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a solution of known resistivity. An apparent resistivities in the refractory portion and


increase of 15% in the resistivity of the other parts of the electrical cycle were essen-
standard solution was observed. In making tially the same. Corrections of the measured
resistivity measurements on liver and heart values which take account of the effect of the
with the same electrodes, it proved difficult curved surface and the proximity of the
to place the electrode structure so that the underlying blood layer were estimated by
electrode surfaces were consistently at dis- mathematical analyses. Since these were al-
tances greater than 0.5 cm from the air ways less than 20% and in opposite directions
boundaries. The latter therefore may be a for the two variables, the net correction re-
contributing factor to the higher results ob- quired was assumed negligible.
tained for several tissues with the catheter The results of the four-electrode measure-
electrode. ments showed a slight anisotropy of about
To summarize, we have obtained a value 2:1 with a high resistivity value of 563 ohm-
of 700 ohm-cm for the resistivity of liver cm and a low resistivity value of 252 ohm-cm.
using the four-electrode method. On the other The per cent standard deviations were ± 15%
hand, using techniques similar to those em- and ± 30% for the high and low values
ployed by Schwan and Kay, their published respectively. These are considerably lower
value of 840 ohm-cm was obtained. The than the value of 965 ohm-cm measured by
higher values of the latter technique may be Sehwan and Kay. Their results however, were
attributed to polarization and/or boundary obtained by measurements following poison-
effects. ing of the experimental animal and cessation
Heart of all electrical activity in the heart; and
The resistivity of the muscle of the left therefore may not be representative of resis-
ventricular wall of the dog heart was meas- tivity values prior to that time.
Circulation Research, Volume XII, January 196S
TISSUE EESISTANCE 45

To investigate this question, a catheter vide the correct degree of lung inflation, the
electrode and bridge was again employed respirator pressure was monitored by a water
with a visual detection device (ECG pen). manometer and adjusted to provide a peak
Crude balances could readily be obtained in pressure equal to the peak pressure normally
this fashion without affecting the heart's existing between the pleural cavity and the
action significantly and the mean value at trachea, i.e., 8 mm of Hg.s The haunches
50 cycles was thus determined to be 516 ohm- were raised 5.5 cm to compensate for the
loss of negative intrathoracic pressure thereby
cm, in addition, upon administration of lethal
minimizing the change in venous return due
doses of barbiturates, a rapid rise in resistiv-
to this factor. The electrodes were held in
ity followed. In two such experiments in- place manually and resistivity measurements
creases of 25% in 15 minutes were observed. were taken at the extremes of inflation and
The value 516 ohm-cm obtained by us with deflation.
the catheter electrode is to be compared to
The resistivities corresponding to the peak
the result obtained using electrode Set A.
of inflation and maximum deflation during
Analytical considerations, based on the poten-
the forced breathing cycle, were found to be
tial solution for a sphere in an anisotropic
2,390 and 1,950 ohm-cm respectively, with a
medium,7 indicates that the catheter elec-
mean of 2,170 ohm-cm. The per cent standard
trode should measure about 1.13 vW>i- Thus,
deviation of the measurements was ± 17%.
there is actually a fairly small discrepancy
between the results obtained by the two The ratio of lung resistivities as measured
methods corresponding to the figures 516 and by ourselves and Schwan and Kay can be
430 ohm-cm. Again the former quantity is seen from table 1 to be about 2:1. The meas-
uncorreeted for polarization effects and pos- urements of the latter group have the advan-
sible boundary influences both of which tend tage over ours of being performed in a closed
chest. On the other hand, the catheter elec-
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to give high values. In addition, the elec-


trodes are not spherical in shape and the trode assembly was placed in the bronchi or
analysis on this basis may contribute to the pulmonary arteries which are conceded to
difference. have an effect on the measurements.3 The
magnitude of this effect was estimated by
To summarize, the measurement of the Schwan and Kay from measurements on ex-
muscle of the left ventricle of the heart cised bronchi. Measurements of excised tis-
shows a resistivity ratio of about 2:1 with sues, however, may not yield values repre-
Pi = 252 and ph = 563 ohm-cm. These values sentative of their in situ characteristics. In
are far below that of 965 ohm-cm given by addition, it was not possible to observe the
Schwan and Kay whose technique ignored the actual situation around the electi'odes with
anisotropy and involved elimination by regard to their location, tightness of fit of
poison of the electrical activity of the heart. the bronchi about the electrode, collection of
By omitting the last mentioned step from fluid about the electrodes, proximity to major
the catheter-electrode procedure, values in blood vessels and possible collapse of the
reasonable agreement with the theoretical lung about the plugged airway.
estimates of such a measurement based on In the present study, measurements were
the p\ and PI, given above, were obtained. made at a variety of locations with the elec-
Lung trodes in view on the outer surface of the
Electrode Set A, modified slightly to pre- lung. Factors which arose from the open
vent piercing of the delicate tissue, was used chest condition were accounted for as de-
to measure the resistivity of lung. The dog scribed. In addition, measurements of the
was placed in a crouching position and lung made through the pleural membrane in
opened on both sides of the thorax at the an intercostal space with the chest interior
fifth and/or sixth intercostal space. To pro- still airtight, though too erratic to give quan-
Circulation Research, Volume ~X.ll, January 196S
46 RUSH, ABILDSKOV, McFEE

TABLE 2
Results of 4-Electrode Measurements of Skeletal Muscle
Parameter Per cent
Electrode (average Value standard Number of
configuration Tissue value) ohm-cm deviation measurements
A (longissimus dorsi Pi, 1885 48% 14
and spinalis dorsi
A et cervicis PI 205* 40% .14
A muscles of dog) (PLPI)1/2 588 10% 14
G human arm muscle PI itiOt 10% 5

*Pi is obtained by combining direct measurements of VPi,/>i and p (see equations 4 and 5).
tMeasurenients of arm corrected for bone and fat, but not for deviations of fiber directions
from axis of measurement.

titative results, clearly indicated a resistivity Skeletal Muscle


much higher than the 1,100 ohm-cm reported The resistivity of skeletal muscle was meas-
by Schwan and Kay. ured with electrodes Sets A, B, and C. The
Finally, since the measurements discussed marked anisotropy of the muscle presented
were made in different regions of the lung, special difficulties necessitating a fairly com-
plicated procedure to obtain both the high and
one in the interior and the other on the
low resistivity values with satisfactory accu-
outer portion, it is possible that both are
racy. The final results, table 1, are 2,300 and
correct representations of the conditions in
150 ohm-cm in directions transverse and
their respective regions. parallel respectively to the muscle fibers.
To summarize, a mean value of lung tissue Electrode Sets A and B were employed to
resistivity over the breathing cycle has been measure the resistivity of the muscles along
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measured at 2,150 ohm-em. This is in con- the spine of the dog, (these were selected on
trast to a value of 1,120 ohm-cm, reported by the basis of their thickness) in a fashion
Scliwan and Kay. The low values of the lat- similar to that used on the heart. Tn this
ter measurements have been attributed to the case, however, measurements with Set B
uncertain conditions around the electrodes, indicated that visual observation of the fiber
most of which would tend to lower the high directions satisfactorily indicated the parallel
value we have measured, and/or the fact that and transverse directions.
the interior of the lung around the bronchi The results of these measurements, table 2,
and arteries actually may have a lower mean showed \/PIP], = 5SS ohm-cm with a per cent
resistivity than the regions nearer the outer standard deviation of ± 10% and ph = 1,885
lung surfaces. ohm-cm with a per cent standard deviation of
Fat ± 4 8 % . The combination of these values gives
The resistivity of fat was measured with p, = 265 ohm-cm with a per cent standard
electrode Set A on various layers on the deviation of ± 40%. The large spread of the
chest wall of the animal. The results, table 1, measurements of pn is attributed primarily to
show a value of 2,500 ohm-cm with a large the extreme sensitivity of this measurement
per cent standard deviation equal to ± 30%. to the electrode orientation. Errors in orienta-
Sehwan and Kay list a range, 1,500-5,000 tion tend to give lower than true values of
ohm-cm at 1,000 cycles/sec, as the only re- ph, equation 2. The calculations of pi reflect
sistivit3r data on fatty tissue, and these may the variability of the p,, measurements. On
be considered in agreement with the results the basis of these results it was concluded
of this study. Further discussion of the sub- that the measurement of \/PHPI w a s satisfac-
cutaneous fat layer will be found in the sec- tory but that other procedures described later,
tion on skeletal muscle. were necessary to evaluate ph and p,.
Circulation Research, Volume XII, January 1963
TISSUE RESISTANCE 47

An independent estimate for Pi was de- The non-parallel orientation of the muscle
duced from the measurements on the human fibers was considered also. For anisotropic
arm. Electrode Set C was used. Current elec- materials with a high ratio of resistivities,
trodes were located on opposite wrists. Poten- analysis shows that the appropriate correc-
tial electrodes were located on the dorsal tion factor is closely related to the additional
surface of the forearm approximately 5 cm length of the fibers, due to skewed directions,
distal from the elbow. The mean longitudinal between two planes perpendicular to the
resistivity of the arm was computed using
axis. The maximum mean deviation of the
equation 4. This measurement reflects pri-
fiber directions, as read from an anatomical
marily the value of p\ but corrections for the
effect of bone, subcutaneous fat, and skewed atlas, from a direction parallel to the axis
fiber directions are necessary. The correc- was estimated to be 30°. The corresponding
tions for bone and fat are based on equation factor, cos 30° = 0.875, applied to the upper
5. bound of 160 ohm-cm yields a value of 140
ohm-cm as a lower bound. The mean of this
The bone was taken as a non-conductor as
indicated by measurements on the exterior range, i.e., 150 ohm-cm, has been taken as
wall of excised bone and by other investiga- the best estimate for p\ of skeletal muscle.
tors.-' u The effect of marrow was neglected Using the value V^iPn = 588 ohm-cm ob-
because there is no apparent low resistance tained with electrode Set A and p\ = 150
path to the bone interior. The area of the ohm-cm as described above, ph was calculated
bone was taken from an anatomical atlas and to be 2,300 ohm-cm.
was assumed the same on all subjects. Measurements by Burger and van Dongen,
The skin and subcutaneous fat layer of table 1, on rabbit muscle yield 125 to 1,800
the arm were taken to have the same re- ohm-cm, results which closely approximate
sistivity as the fat measured on the chest ours. Their measurements on human arms
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wall with a thickness determined as one- and legs, however, give results for skeletal
half the measured skin-fold dimension. To muscle which are lower for ph and higher for
substantiate this choice of resistivity value Pi. If, in computing p\, they had taken into
two additional considerations were taken account the subcutaneous fat and the im-
note of. First, while attempts to measure the perfect alignment of the muscle fibers with
resistivity directly of this layer on the dog the axes of the arm and leg, their results
gave erratic results the minimum estimate for this parameter would have been compara-
so obtained was of the order of 900 ohm-cm. ble to ours. The low values they attributed
In view of the relatively small cross-sectional to ph from measurements transverse to the
area of fat relative to the total arm cross- axes of the arm and leg may have been due
section and the shunting effect of the muscle, to the deviations of muscle fiber directions
even this lowest value would change the fig- from these axes. Even small deviations of
ures presented by no more than 6%. Second, this type can be shown to have a very large
statistical considerations indicate that the fat effect on their transverse measurements.
corrections improve the data. For example, The value presented by Schwan and Kay
the per cent standard deviation of measure- for muscle, 965 ohm-cm, represents some
ments of the arm before fat corrections was kind of mean value of resistivity for aniso-
± 20% while the same statistic was reduced tropic tissue. An analysis similar to thai
by the corrections to ± 9%. described in the discussion of the heart
These two corrections for inhomogeneity, indicates that according to our results, the
that is for bone and fat, applied to the value catheter-electrode should have given values
of 234 ohm-cm for the whole arm, give a between 820 and 700 ohm-cm depending on
value for the longitudinal resistivity of the electrode orientation. As in the measurements
muscle of 160 ohm-cm. of liver and heart, the two-electrode tech-
Circulation Rtw.arch, Volume XII, January 1903
48 RUSH, ABILDSKOV, McFEE

which is reported in table 1, i.e., 162 ohm-cm.


Further, of these studies, two were made
with a four-electrode technique and two with
a two-electrode technique. Correction factors
on which there is substantial agreement,
were necessary to normalize all the results
Radial direction to a common temperature of 37°C.
The value of 100 ohm-cm mentioned by
Longitudinal Schwan and Kay 3 ' 9 for human blood is
Transverse direction based primarily on measurements of sheep
direction blood.12 It is well known, however, that blood
resistivity is critically dependent on the
hematocrit which in turn is a function of
red cell size and count.10 The last mentioned
factors are markedly different for sheep than
for humans or dogs. By using the data on
blood count and serum resistivity given in
Schwan's paper and relating the blood count
to hematocrit from data on sheep blood counts
FIGURE 6 and hematocrits given by Wintrobe,13 it is
Reference directions on torso. possible to reconcile the 100 ohm-cm value
for sheep blood quite naturally with the
values for human blood quoted here.
nique gave results about 20% higher than
the four-electrode measurement. Thorax
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To summarize, a value of 150 ohm-cm for A number of measurements of the human


P\ of skeletal muscle was deduced from var- thorax, dog thorax and of dog thorax minus
ious measurements of the whole arm and heart and lungs were made with electrode
tissues therein. The geometric mean of the Set C. The current electrodes were connected
resistivities, y/ptj>i, was obtained from direct as described earlier. The potential electrodes
measurements on skeletal muscle with elec- were placed along a line parallel to the spine
trode .Set A. The combination of results gave on the side of the body. They were spaced
the high resistivity value, ph, as 2,300 ohm-cm. 6 cm apart and centered at the level of the
These numbers agree reasonably with other center of the heart.
direct measurements on muscle; those of Seven measurements were thus made of the
Burger and van Dongen on rabbit muscle resistivity of the human thorax with a mean
and those of Schwan and Kay on dog mus- of 463 ohm-cm.
cle. In addition, the method of obtaining On the intact dog thorax, a mean of 445
these results, i.e., by correcting for the fat ohm-cm was measured.
layer, explains how the human arm resistiv- To measure the thorax minus heart and
ities given by Burger and van Milaan and lungs, the dog was placed supine and opened
Burger and van Dongen are to be reconciled along the sternum. The inferior vena cava
with the latter group's measurements of p, and esophagus were cut and tied and the
of rabbit muscle. heart and lungs encased in a plastic bag,
Blood after which the measurements were made.
Measurements of human blood resistivity The cross-sectional area of the exterior shell
were not carried out in this study. The litera- was obtained by moulding a strip of solder
ture of four2' *• 9p10 investigations shows around its perimeter. This mould was later
agreement within ± 3% of their mean value traced and the area measured with a planim-
Circulation Research, Volume XII, January 1963
TISSUE RESISTANCE 49

eter. The average of two such measurements


of the shell resistivity was 281 ohm-cm.
The results obtained for the human thorax
were compared with an alternate estimate of
the mean thorax resistivity based on the
resistivities of the individual tissues, equa- FIGURE 7
tion 5. The tissue resistivities used were those Schematics of resistivity models of thorax.
obtained in this study. The tissue cross-sec-
tional areas were obtained by averaging the
The mean resistivity of the human and dog
areas shown in Sections 25 and 26 of Eyclesh-
thorax was measured in a direction parallel
ymer and Schoemaker's/l Cross-Section Anat-
to the spine using electrode configuration ' C'.
omj/. In order to treat the highly aniso-
The values given for human blood have been
tropic muscles of the chest as a single tissue
obtained from the literature. These results
in equation 5, it was necessary to choose a
are also presented in table L
representative value for the muscle resistiv-
ity in the thorax measurement. Anatomical Discussion
data show the different muscles on the chest It was necessary to make most individual
almost randomly distributed over the longi- tissue measurements (fat, lung, heart muscle
tudinal and transverse directions (fig. 6). and liver) on dogs and to assume that these
Theoretical considerations, based on random are representative of human tissue. The near
directions, give (IR/2) p\ as the appropriate equality of the mean thorax resistivities of
value for muscle in the thorax measurement. humans and dogs supports this assumption.
The mean value for the thorax based on That the predicted value of human thorax
individual tissue measurements was thus cal- resistivity, based on measurements reported
in column 5 of table 1 and anatomical data,
Downloaded from http://ahajournals.org by on July 4, 2019

culated from equation 5 to be 500 ohm-cm;


8% higher but substantially in agreement is within 8% of the value of the measured
with the value measured on the trunk ex- thorax resistivity; lends some support also
terior. to the measurements on the individual tissues.
SUMMARY OF RESULTS
The existence of a surface layer of low
The resistivities of lung, fat and liver as resistivity covering the thorax is of signifi-
measured by the four-electrode Set A are cance in electrocardiograph}7. McFee and
contained in table 1. The per cent standard Parungao10 have reported an anomalous effect
deviations of the readings from their means in making measurements on lead systems
are 17%, 30% and 14% respectively. The which they attribute to this factor.
values of resistivity reported for heart mus- The work reported here has bearing on the
cle in table 1 are those obtained by assuming models used to investigate the nature of elcc-
the heart to be a semi-infinite homogeneous trocardiographic leads. Among such models
anisotropic medium bounded by a plane sur- previously used are (a) the homogeneous
face. The per cent standard deviations for ph thorax, (b) the homogeneous heart-blood
and PI are 15% and 30% respectively. The mass with higher resistance exterior,16 and
estimates of pt and ph for skeletal muscle (c) blood cavities of low resistivity sur-
reported in table 1 were obtained by combin- rounded by homogeneous tissue of resistivity
ing a variety of measurements as explained ten times higher.0 The data of this study
earlier. Eesults of actual measurements with present a more complex picture as can be
electrode Sets A and C are reported in table seen in the schematic drawing of figure 7 in
2 for the longissimus dorsi and spinal is dorsi which a mean resistivity of 400 ohm-cm for
et cervicis muscles along the spine of the the outer thorax layer; skin, fat, muscle, and
dog and for the human arm muscle. bone has been used,
Circulation Research, Volume XII. January 196$
50 RUSH, ABILDSKOV, McFEE

Summary 5. HEILAND, C. A.: Geophysical Exploration. New


The resistivity of tissues of the thorax of York, Prentice-Hall, 1940, p. 29.
dogs has been measured in situ under nearly 6. HEILAND, C. A.: op. cit., p. 645.

normal conditions. Additional data have been 7. BUSH, S.: Methods of measuring the resistivities
obtained from humans. of anisotropie conducting media in situ. Journal
of Research of the National Bureau of Stand-
Approximate values of tissue resistivity ards, Section C: Vol. 66C, No. 3, July-Sep-
found are 160 ohm-cm for blood, 2,000 ohm- tember, 1962.
cm for lung, 2,500 ohm-cm for fat, 700 ohm- 8. FULTON, J. F . : Howell's Textbook of Physiology.
cm for liver, 250 and 550 ohm-cm (aniso- loth Ed., Philadelphia, W. B. Saunders Co.,
tropic) for heart muscle and 150 and 2,500 1946, p. 866.
ohm-cm (anisotropic) for skeletal muscle. 9. SCHWAN, H. P., AND KAY, C. F . : The conduc-
Reasons for the differences between these and tivity of living tissues. Annals of N. Y. Acad.
previously reported values have been found, of Sci., vol. 65, Art. 6: 1007, 1957.
and in some cases, verified experimentally. 10. HIRSCH, F. G., et al.: The electrical conduc-
Predictions of whole trunk resistivity based tivity of blood, I. Relationship to erythrocyto
on anatomical data and these measurements concentration. Blood 5: 1017, 1950.
are within 8% of actual trunk measurements. 11. ROSENTHAL, R. L., AND TOBIAS, C. W.: Electrical
resistance of human blood. Journal of Lab.
References and Clin. Med. 33: 1110, 194S.
1. KAUFMAN, W., AND JOHNSTON, F. D.t The elec- 12. RAJEWSKY, B., AND SCHWAN, H. P . : Uber die
trical conductivity of the tissues near the individuelen Schwankungen des spczifischen
heart and its bearing on the distribution of Widcrstnndos von Blut und Serum. Zeit. f.d.
cardiac action currents. Am. Heart J. 26: ges. exp. Med. 113: 553, 1944.
42, 1943.
.13. WINTROBE, M. M.: Clinical Hematology, 4th Kd.,
2. BURGER, H. C, AND VAN MILAAN, J. B.: Measure-
ments of the specific resistance of the human Philadelphia, Lea & Fobiger, 1956, p. 1129.
Downloaded from http://ahajournals.org by on July 4, 2019

body to direct current. Act. Med. Sennd. 114: 14. EYCLESHYMER, A. C, AND SCHOEMAKER, D. M.:
584, 1943. A Cross-Section Anatomy, New York, Appleton-
3. SCHWAN, H. P., AND KAY, C. F . : Specific resist- Century-Crofts, Inc., 1911, pp. 65 and 67.
ance of body tissues. Circulation Research 4: 15. MCFEE, R., AND JOHNSTON, F. I).: Elcctro-
664, 1956. cardiographic leads. Circulation 9: 868, 1954.
4. BURGER, H. C, AND VAN DONGEN, R.: Specific 16. MCFEE, R., AND PARUNGAO, A.: An orthogonal
electrical resistance of body tissues. Physics lead system for clinical electrocardiograph}'.
in Medicine and Biology, vol. 5, 4: 431, 196.1. Am. Heart J. 62: 93, 1961.

Circulation Rcucarch, Volume A'//, January 1963

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