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Cardiac Arrhythmias pp 1–3Cite as

Anatomy and Physiology of the Atrioventricular Node: Basic Concepts

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Abstract

To appreciate the arrangement of the muscular connections between the atrial walls and the compact atrioventricular node, it is necessary to understand their anatomic relationships. Koch described the landmarks to the atrioventricular node that many subsequent investigators have illustrated the conduction axis running horizontally rather than vertically. The cardiac electrical physics is the “soul” of the heart, and hence, understanding of anatomy and physics is critical to unlocking the understanding of electrical workings and facilitates ablation procedures.

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References

  1. Fisch C. Electrocardiographic manifestation of dual AV nodal conduction during sinus rhythm. In: Mazgalev TN, Tchou PJ, editors. Atrial-AV nodal electrophysiology: a view from the millennium. Armonk: Futura Publishing Co., Inc; 2000.

    Google Scholar 

  2. Moe GK, Cohen W, Vick RL. Experimentally induced paroxysmal A-V nodal tachycardia in the dog. Am Heart J. 1963;65:87–92.

    Article  Google Scholar 

  3. Mendez C, Moe GK. Demonstration of a dual AV nodal conduction system in the isolated rabbit heart. Circ Res. 1966;19:378–93.

    Article  CAS  PubMed  Google Scholar 

  4. Janse MJ, Loh P, de Bakker JMT. Is the atrium involved in AV nodal reentry? In: Mazgalev TN, Tchou PJ, editors. Atrial-AV nodal electrophysiology: a view from the millennium. Armonk: Futura Publishing Co., Inc; 2000.

    Google Scholar 

  5. de Paes Carvalho A, de Almeida DF. Spread of activity through the atrioventricular node. Circ Res. 1960;8:808–9.

    Google Scholar 

  6. Moe GK, Preston JB, Burlington H. Physiologic evidence for a dual A-V transmission system. Circ Res. 1956;4:357.

    Google Scholar 

  7. Zipes DP. Voltage dependency in rabbit atrioventricular nodal fibers. Circ Res. 1973;33:123–30.

    Article  Google Scholar 

  8. Rosen KM, Denes P, Wu D, Dhingra RC. Electrophysiological diagnosis and manifestation of dual A-V nodal pathways. In: Wellens HJJ, Lie KI, Janse MJ, editors. The conduction system of the heart. Leiden: HE Stenfert Kroese BV; 1976. p. 453–66.

    Google Scholar 

  9. Zipes DP, Mendez C, Moe GK. Evidence for summation and voltage dependency in rabbit atrioventricular nodal fibers. Circ Res. 1973;32:170–7.

    Article  CAS  PubMed  Google Scholar 

  10. Langberg JJ, Leon A, Borganelli M, et al. A randomized, prospective comparison of anterior and posterior approaches to radiofrequency catheter ablation of atrioventricular nodal reentry tachycardia. Circulation. 1993;87:1551–6.

    Article  CAS  PubMed  Google Scholar 

  11. Fishberger SB. Radiofrequency ablation of probable atrioventricular nodal reentrant tachycardia in children with documented supraventricular tachycardia without inducible tachycardia. Pacing Clin Electrophysiol. 2003;26(8):1679–83.

    Article  PubMed  Google Scholar 

  12. Jackman WM, Beckman KJ, McClelland JH, et al. Treatment of supraventricular tachycardia due to atrioventricular nodal reentry, by radiofrequency catheter ablation of slow-pathway conduction. N Engl J Med. 1992;327:313–8.

    Article  CAS  PubMed  Google Scholar 

  13. Lee PC, Hwang B, Tai CT, Chen SA. Electrophysiological characteristics in patients with ventricular stimulation inducible fast-slow form atrioventricular nodal reentrant tachycardia. Pacing Clin Electrophysiol. 2006;29:1105–11.

    Article  PubMed  Google Scholar 

  14. Knight BP, Ebinger M, Oral H. Diagnostic value of tachycardia features and pacing maneuvers during paroxysmal supraventricular tachycardia. J Am Coll Cardiol. 2000;36(2):574–82.

    Article  CAS  PubMed  Google Scholar 

  15. Neyton J, Trautmann A. Physiological modulation of gap junction permeability. J Exp Biol. 1986;124:93–114.

    Google Scholar 

  16. Bennett MVL, Goodenough DM. Gap junctions, electrotonic coupling and intercellular communication. Neurosci Res Program Bull. 1978;16:373–486.

    Google Scholar 

  17. Caspar DLD, Goodenough DA, Makowski L, Phillips WC. Gap junction structures. I. Correlated electron microscopy and X-ray diffraction. J Cell Biol. 1977;74:605–28.

    Article  CAS  PubMed  Google Scholar 

  18. Caveney S. Intercellular communication in insect development is hormonally controlled. Science. 1978;119:192–5.

    Article  Google Scholar 

  19. Dahl G, Isenberg G. Decoupling of heart muscle cells: correlation with increased cytoplasmic calcium activity and with changes of nexus ultrastructure. J Membr Biol. 1980;53:63–75.

    Article  CAS  PubMed  Google Scholar 

  20. Tawara S. The conduction system of the mammalian heart. Translated by Kozo Suma and Munehiro Shimada. London: Imperial College Press, 2000.

    Google Scholar 

  21. Waller BF, Gering LE, Branyas NA, Slack JD. Anatomy, histology, and pathology of the cardiac conduction system: part I. Clin Cardiol. 1993;16:249–52.

    Article  CAS  PubMed  Google Scholar 

  22. Geller JC, Biblio LA, Carlson MD. New evidence that the AV node slow pathway conduction directly influences fast pathway conduction. J Cardiovasc Electrophysiol. 1998;9:1026–35.

    Article  CAS  PubMed  Google Scholar 

  23. Lee S, Tai CT, Lee PC, Chiang CE, Cheng JJ, Ueng KC, Chen YJ, Chen SA. Electrophysiological characteristics of functional rhythm during ablation of slow pathway in different types of atrioventricular nodal reentrant tachycardia. Pacing Clin Electrophysiol. 2005;28:11–118.

    Article  Google Scholar 

  24. Meijler FL, Jalife J. AV node functions during atrial fibrillation. In: Mazgalev TN, Tchou PJ, editors. Atrial – AV nodal electrophysiology: a view from the millennium. Armonk: Futura Publishing Co., Inc; 2000.

    Google Scholar 

  25. Lin YK, Ms L, Chen YC, Chen CC, Huang JH, Chen SA. Hypoxia and reoxygenation modulate the arrhythmogenic activity of the pulmonary vein and atrium. Clin Sci (Lond). 2012;122:122–32.

    Google Scholar 

  26. Rudy Y. Principles of slow conduction in cardiac tissue; mathematical modeling. In: Mazgalev TN, Tchou PJ, editors. Atrial – AV nodal electrophysiology: a view from the millennium. Armonk: Futura Publishing Co., Inc.; 2000.

    Google Scholar 

  27. Mazgalev T, Tchou P. Atrioventricular nodal conduction gap and dual pathway electrophysiology. Circulation. 1995;92(9):2705–14.

    Article  CAS  PubMed  Google Scholar 

  28. Billette J, Janse MJ, van Capelle FJL, Anderson RH, Touboul P, Durrer D. Cycle-length dependent properties of AV nodal activation in rabbit hearts. Am J Physiol. 1976;231:1129–39.

    CAS  PubMed  Google Scholar 

  29. Schuilenburg RM, Durrer D. Atrial echo beats in the human heart elicited by induced atrial premature beats. Circulation. 1968;37:680–93.

    Article  CAS  PubMed  Google Scholar 

  30. Fishberger SB, Whalen R, Zahn EM, Welch EM, Rossi A. Radiofrequency ablation of pediatric AV nodal reentrant tachycardia during the ice age: a single center experience in the cryoablation era. Pacing Clin Electrophysiol. 2010;33(1):6–10.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Cardiology, Center Hospitalier Coutances, Coutances, France

    Ambrose S. Kibos MD

  2. Cardiovascular Surgery Department, Army’s Clinic Center for Cardiovascular Diseases, Bucharest, Romania

    Blanca F. Calinescu MD

Authors
  1. Ambrose S. Kibos MD
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  2. Blanca F. Calinescu MD
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Corresponding author

Correspondence to Ambrose S. Kibos MD .

Editor information

Editors and Affiliations

  1. Department of Cardiology, Center Hospitalier Coutances, Coutances, France

    Ambrose S. Kibos

  2. Department of Internal Medicine Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA

    Bradley P. Knight

  3. Division of Cardiology, McGill University Health Center, Montreal, Québec, Canada

    Vidal Essebag

  4. Department of Cardiology, Miami Children's Hospital, Miami, Florida, USA

    Steven B. Fishberger

  5. School of Biology, Chemistry and Health, Manchester Metropolitan University, Manchester, United Kingdom

    Mark Slevin

  6. “Acad. Vasile Candea” Emergency Clinical Center for Cardiovascular Diseases, “Carol Davila” University of Medicine and Pharmacy, “Titu Maiorescu” University Faculty of Medicine,, Bucharest, Romania

    Ion C. Țintoiu

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© 2014 Springer-Verlag London

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Kibos, A.S., Calinescu, B.F. (2014). Anatomy and Physiology of the Atrioventricular Node: Basic Concepts. In: Kibos, A., Knight, B., Essebag, V., Fishberger, S., Slevin, M., Țintoiu, I. (eds) Cardiac Arrhythmias. Springer, London. https://doi.org/10.1007/978-1-4471-5316-0_1

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  • DOI: https://doi.org/10.1007/978-1-4471-5316-0_1

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5315-3

  • Online ISBN: 978-1-4471-5316-0

  • eBook Packages: MedicineMedicine (R0)

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