Electrical activity in sinus node and atrioventricular node

Kooi, M.W. van der; Durrer, D; Dam, R. Th. van; Tweel, L. H. van der

doi:10.1016/s0002-8703(56)80005-7

Cited by 63 publications

(21 citation statements)

References 15 publications

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“…What is the general relationship between the excitation wave front depicted by instantaneous isochronous time lines to the position of maxima and minima and the field of positive and negative potentials? Van der Kooi and co-workers (7) noted that local excitation as timed with a bipolar lead coincided precisely with the most rapid portion of the intrinsic deflection of atrial unipolar electrograms. To examine this time relationship, four dogs underwent acute atrial excitation studies whereby a bipolar electrode with the terminals 1 mm apart was used to record bipolar and unipolar electrograms simultaneously 1 .…”

Section: Considerations Regarding the Methodsmentioning

confidence: 92%

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Electrical Potential Distribution Surrounding the Atria during Depolarization and Repolarization in the Dog

Spach

King

Barr

et al. 1969

Circulation Research

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The potential distribution at the atrial surface during depolarization and repolarization was studied in intact dogs. A preparation was developed by implanting 30 to 40 miniature electrodes permanently on each atrium to record unipolar electrograms in the intact animal. Heart block was created to dissociate atrial and ventricular activity. The electrograms were recorded on magnetic tape and atrial isopotential heart maps produced with the use of a digital computer. The changing potential distribution during excitation indicated the early presence of multiple wave fronts which were related primarily to the crista terminalis, Bachmann's bundle, and a special bundle to the base of the right appendage. The interatrial septum provided a conducting bridge which had an important influence of global atrial excitation, depending on the site of impulse formation. Colliding excitation wave fronts were quite prominent. During terminal atrial excitation, repolarization maxima were present simultaneously with depolarization maxima. Repolarization was characterized by a changing potential distribution which followed the same general pattern as excitation spread; and, furthermore, the earliest areas of excitation were associated with a repolarization maximum and terminal areas of excitation were associated with repolarization minima. surface recordings. Since we cannot hope to rationally understand the ultimate value and limitations of atrial body surface activity until we better understand the nature of electrical activity at the atrial surface, it seemed wise to examine further two separate but closely related electrophysiologic questions. (1) What are the characteristics of the field of potentials surrounding the atrium during depolarization? (2) What is the nature of the atrial potentials generated during repolarization?The classic work of Lewis and co-workers (4) in the dog initially presented evidence for radial spread of activation of the atria. Eyster and Meek (5) challenged Lewis's work since they found evidence of asymmetrical spread from the SA node area. Puech and co-workers (6), van der Kooi et al. 858 SPACH, KING, BARR, BOAZ, MORROW, HERMAN-GIDDENSof initial wave fronts which spread inferiorly from the SA node; however, these investigators concluded that atrial excitation was principally characterized by radial spread. The question of radial versus asymmetrical spread of atrial activation remains unsettled. This is due primarily to the lack of detailed physiologic data to deny or confirm the theory of concentric conduction as related to the total excitation sequence of both atria. Additionally, the nature of repolarization of a mass of myocardial tissue remains at a primitive stage of understanding. To gain insight into this latter problem, we considered the atrium to provide the particular advantage of a tworather than three-dimensional problem due to the thin chamber walls, although the global geometry of the atrium is somewhat complex (9) because of the appendages and venous connections.This study was ...

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Section: Considerations Regarding the Methodsmentioning

confidence: 92%

“…Eyster and Meek (5) challenged Lewis's work since they found evidence of asymmetrical spread from the SA node area. Puech and co-workers (6), van der Kooi et al (7), and Sano and Yamagishi (8) …”

mentioning

confidence: 99%

Electrical Potential Distribution Surrounding the Atria during Depolarization and Repolarization in the Dog

Spach

King

Barr

et al. 1969

Circulation Research

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“…Hariman et al (1980) defined primary negativity as a -dV/dt > 25 mV/sec, not preceded by a positive deflection due to atrial activity. Van der Kooi et al (1956) demonstrated small 'prepotentials* which preceded the earliest atrial deflections ascribed to SN activity. We were not able to observe these low amplitude deflections in our electrograms recorded from areas of primary negativity.…”

Section: Significance Of Primary Negativity At Single and Multiple Sitesmentioning

confidence: 99%

Activation sequence and potential distribution maps demonstrating multicentric atrial impulse origin in dogs.

Boineau¹,

Miller²,

Schuessler³

et al. 1984

Circulation Research

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SUMMARY. We examined the onset of atrial epicardial excitation by recording unipolar potentials from 360 electrodes arranged in templates affixed to the superior vena cava and right atrium in dogs. Both activation sequence and potential distribution maps were obtained for the period of impulse origin beginning before the surface P wave and continuing through the first 15-20 msec of atrial depolarization. The activation maps demonstrated impulse origin from multiple widely separated sites, resulting in two to three individual wavefronts that merged to form a single widely disseminated wavefront spread over a 50 x 20 mm area by 10-15 msec. Atrial potential maps obtained for the same time periods revealed multiple sites of primary negativity corresponding to the points of impulse origin in the activation maps. The potential distributions and evolution of these maps also indicated the presence of multiple wavefronts originating from widely separated locations, and suggested an extensively dispersed source of impulse origin. One of these sites at the superior cavo-appendicular junction corresponded to the rostral portion of the sinus node and the site of classical unifocal origin. Additional sites of impulse origin and primary negativity distant to the sinus node were noted either concurrently in the same map or in other maps associated with different patterns of impulse initiation. Classical physiological and pharmacological interventions were used to alter adrenergjc and cholinergic input to the atrium, and resulted in coincident changes of both the patterns of impulse origin and heart rate. In addition, we examined spontaneous changes in the patterns of impulse initiation which accompanied beat-tobeat changes in cycle length (sinus arrhythmia). There was close agreement between activation and potential maps over the entire steady state and dynamic range of impulse origin. The data can be explained by the concept of a widely distributed system of functionally differentiated but coordinated atrial pacemakers. (Circ Res 54: 332-347, 1984)

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“…There are only a few studies in which extracellular electrodes were used to record directly from the AV node (4,5,47,150,161,170,187). The interpretation of most extracellular waveforms recorded from the nodal area is very difficult.…”

Section: B Pattern Of E Xcitation Ofthe a V Nodementioning

confidence: 99%

Morphology and electrophysiology of the mammalian atrioventricular node

Meijler

Janse

1988

Physiological Reviews

205

146

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The AV node of those mammalian species in which it has been thoroughly investigated (rabbit, ferret, and humans) consists of various cell types: transitional cells, midnodal (or typical nodal cells), lower nodal cells, and cells of the AV bundle. There are at least two inputs to the AV node, a posterior one via the crista terminalis and an anterior one via the interatrial septum, where atrial fibers gradually merge with transitional cells. The role of a possible third input from the left atrium has not been investigated. Since the transition from atrial fibers to nodal fibers is gradual, it is very difficult to define the "beginning" of the AV node, and gross measurements of AV nodal length may be misleading. Histologically, the "end" of the AV node is equally difficult to define. At the site where macroscopically the AV node ends, at the point where the AV bundle penetrates into the membranous septum, typical nodal cells intermingle with His bundle cells. A conspicuous feature, found in all species studied, is the paucity of junctional complexes, most marked in the midnodal area. The functional counterpart of this is an increased coupling resistance between nodal cells. An electrophysiological classification of the AV nodal area, based on transmembrane action potential characteristics during various imposed atrial rhythms (rapid pacing, trains of premature impulses), into AN (including ANCO and ANL), N, and NH zones has been described by various authors for the rabbit heart. In those studies in which activation patterns, transmembrane potential characteristics, and histology have been compared, a good correlation has been found between AN and transitional cells, N cells and the area where transitional cells and cells of the beginning of the AV bundle merge with midnodal cells, and NH cells and cells of the AV bundle. Dead-end pathways correspond to the posterior extension of the bundle of lower nodal cells and to anterior overlay fibers. During propagation of a normal sinus beat, activation of the AN zone accounts for at least 25% of conduction time from atrium to His bundle, the small N zone being the main source of AV nodal delay. Cycle length-dependent conduction delay is localized in the N zone. Conduction block of premature atrial impulses can occur both in the N zone and in the AN zone, depending on the degree of prematurity. Several factors determining AV nodal conduction delay have been identified.(ABSTRACT TRUNCATED AT 400 WORDS)

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Electrical activity in sinus node and atrioventricular node

Cited by 63 publications

References 15 publications

Electrical Potential Distribution Surrounding the Atria during Depolarization and Repolarization in the Dog

Electrical Potential Distribution Surrounding the Atria during Depolarization and Repolarization in the Dog

Activation sequence and potential distribution maps demonstrating multicentric atrial impulse origin in dogs.

Morphology and electrophysiology of the mammalian atrioventricular node

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