Objective To precisely visualize cardiac anatomic structures and simultaneously depict ele ctro-mechanical events for the purpose of precise underblood intervention. Methods Intracardiac high-resolution tissue Doppler imaging was used to map realt imemyocardial contractions in response to electrical activation within the anat omic structure of the cardiac conductive system using a canine open-chest model . Results The detailed inner anatomic structure of the cardiac conductive system at differ entsites (i.e., sino-atrial, atrial wall, atrial-ventricular node and ventr icular wall) with the inside onset and propagation of myocardial velocity and ac celeration induced by electrical activation was clearly visualized and quan titatively evaluated.Conclusion The simultaneous single modality visualization of the anatomy, function and electrical events of the cardiac conductive system will foster target pacing and pre cision ablation.