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Atrial Fibrillation pp 47–76Cite as

Models of the Atrioventricular Node

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Abstract

The mechanism of the ventricular response in atrial fibrillation has long been a puzzle, the answer to which lies in the working of the atrioventricular node. Any attempted solution must be consistent with, and preferably also illuminate, the known behaviour of the atrioventricular node in sinus rhythm. Essentially, the problem is mathematical: how to convert the distribution and sequence of impulses arriving at the atrioventricular node to those of the impulses leaving the node. However, the mathematical solution has to correspond to the known electrophysiological properties of the conducting system. The main features that need to be accommodated in a model are as follows: reduction of the number of impulses entering the node to the number leaving the node; an essentially random sequence of R-R intervals with the distribution properties found in atrial fibrillation, including the presence of narrow peaks on the histogram of R-R intervals; a relatively long atrioventricular conduction interval in sinus rhythm; rapid change of atrioventricular delay with change of ventricular rate; and a negative relation between cycle length of conducted impulses and the effective refractory period of the atrioventricular node.

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Authors and Affiliations

  1. Department of Medicine and Therapeutics, University of Aberdeen, Foresterhill, Aberdeen, AB9 2ZD, UK

    John Rawles BSc, MB, BS, FRCP, FRCP (Edin)

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  1. John Rawles BSc, MB, BS, FRCP, FRCP (Edin)
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© 1992 Springer-Verlag London Limited

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Rawles, J. (1992). Models of the Atrioventricular Node. In: Atrial Fibrillation. Springer, London. https://doi.org/10.1007/978-1-4471-1898-5_3

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  • DOI: https://doi.org/10.1007/978-1-4471-1898-5_3

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-1900-5

  • Online ISBN: 978-1-4471-1898-5

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