• 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-
Downloaded from http://ahajournals.org by on July 4, 2019
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.
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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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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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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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.
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
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.
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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.
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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}'.
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