Zur Kenntnis der Erregungsausbreitung vom Sinusknoten auf den Vorhof

Rothberger, C. J.; Scherf, David

doi:10.1007/bf02625191

Cited by 77 publications

(9 citation statements)

References 12 publications

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“…As for the ligament, no indication of its relationship to the atria was made other than its composition, i.e., fibrous connective tissue (2). Subsequent electrophysiological studies aud anatomic investigations indicated specific connections between the AV node and the left atrium (9,10). However, these pathways were described as short, diffuse tracts running through the interatrial septum between the AV node and the left atrium.…”

Section: Discussionmentioning

confidence: 99%

Inferior Interatrial Pathway in the Dog

Scherlag

Yeh

Robinson

1972

Circulation Research

107

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In 20 anesthetized dogs, close bipolar electrograms consisting of two deflections were recorded along the ligament of Marshall in the posterior left atrium. At the inferior portion of the ligament the deflections were separated by an interval of 10-15 msec and at the level of the left superior pulmonary vein by an interval of 60 msec or more. Histological and electrophysiological studies indicated that both deflections were associated with striated cardiac muscle; the first deflection was designated as a left atrial muscle potential and the second as a left atrial tract potential. Although the left atrial muscle potential was coincident with the middle portion of the P wave, the left atrial tract potential occurred during some part of the P-R segment. Conduction to the left atrial tract potential was altered, delayed, or completely blocked during retrograde conduction in the atrium, rapid pacing of the atrium (300-500/min), or local cooling at the point where the ligament of Marshall joined the inferior left atrium near the origin of the coronary sinus. Crushing Bachmann's bundle caused delay in conduction to the left atrial muscle but not to the left atrial tract. Left cardiac sympathetic nerve stimulation induced an atrial activation pattern consistent with pacemaker activity in the inferior left atrium, with inversion of the P wave in lead II. Pacing from the edge of the ligament of Marshall in the posterior left atrium produced the same change in P-wave morphology. These data indicate that the left atrial tract represents a terminal, insulated tract which is activated through an inferior interatrial pathway connecting the inferior right and left atria along the coronary sinus. The terminal end of the tract showed no reinsertion into atrial musculature. KEY WORDS bipolar electrogramsHis bundle recordings P waves left atrial rhythms ligament of Marshall atrial tracts cardiac sympathetic nerve stimulation cardiac pacing Bachmann's bundle• Recently there has been a revival of interest in the patterns of atrial activation based primarily on the work of James (1), who described histologically distinct atrial tracts running from the sinoatrial (SA) node to the atrioventricular (AV) node. In 1850 Marshall (2) described the prenatal development of an area of the left atrium running between the superior and inferior left pulmonary veins, which became a ligamentous fold. This structure, now referred to as the ligament

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Section: Discussionmentioning

confidence: 99%

Inferior Interatrial Pathway in the Dog

Scherlag

Yeh

Robinson

1972

Circulation Research

107

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“…Many studies have since evaluated the histological and electrophysiological characteristics of this band and its branches or the nature of putative pathways between the sinus and atrioventricular nodes; however, little anatomic and histological information is available on other interatrial connections. [2][3][4][5][6][7][8] Although Thorel 3 found no relationship between the posterior internodal pathway (in or near the crista terminalis) and the left atrial myocardium, James 7 suggested the possibility of interatrial connections through the atrioventricular nodal tissue or interatrial septum; this was demonstrated by Rossi,9 Sanchez-Quintana et al, 10 and Inoue and Becker. 11 Experiments that involved incising or crushing Bachmann's bundle consistently showed persistent interatrial conduction, with surface ECG morphology indicating a caudocephalad activation of the left atrium and, thus, an inferior right-to-left atrial anatomic connection.…”

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confidence: 99%

The Anatomic Basis of Connections Between the Coronary Sinus Musculature and the Left Atrium in Humans

et al. 2000

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Background-This study determined the histological features of the atrial myocardium connecting the coronary sinus and the left atrium in humans. Methods and Results-Ten necropsied hearts were studied by performing serial longitudinal sections parallel to the long axis of the coronary sinus that extended its full length using a large microtome. In all specimens, the venous wall of the coronary sinus was surrounded by a cuff of striated muscle extending 40Ϯ8 mm from the ostium. Striated myocardial connections of varying number and morphology left this coronary muscle cuff and connected to the left atrium; they ranged from 1 to 2 fascicles to a widely intermingled continuum (thickness, 2.79Ϯ2 mm; width, 2.91Ϯ3.5 mm). These connections originated 8.8Ϯ5.7 mm from the coronary sinus ostium and inserted 18Ϯ11 mm distally into the left atrium. The insulating compartment in which the connections traversed between the left atrium and the coronary sinus was mostly formed of adipose tissue. The valve of Vieussens was found in 6 hearts at a mean distance of 3.4Ϯ3.2 mm from the distal extremity of the coronary sinus muscle cuff. Conclusions-In the human heart, a consistent but morphologically variable left atrial coronary sinus myocardial connection was found. This emphasizes the need for surgical dissection or catheter ablation in or around the coronary sinus to eliminate these connections. (Circulation. 2000;101:647-652.)

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“…This observation, that the complexes in the transverse lead were, so far as QRS was concerned, typical, even when those in the anus-cesophagus lead was quite unlike those usually obtained after section of the right branch, ruled out of court the explanation offered by the previous authors for their results. A lesion of the posterior divisioln of the left bundle branch modifies not only the QRS in the axial lead, but also that of the transverse lead [Rothberger and Winterberg, 1917]. When, as here, the QRS of lead I remains typical for right bundlebranch block, then the changes in the QRS of the axial lead are probably due to some cause other than such a lesion of the left posterior division.…”

Section: Interpretation Of Resultsmentioning

confidence: 88%

“…The rapid onset of the changes on occlusion of the vessels, and the even speedier disappearance on their release, speak strongly against implication of the conducting tissue in the ventricle as playing any part in the electrocardiographic changes. In contrast to the specific tissues of the sinus node and auriculo-ventricular node, which react promptly to oxygen lack [Lewis, White and Meakins, 1913;Rothberger and Scherf, 1927], it is an experimental fact that the conducting tissues in the ventricles are peculiarly resistant to anoxeemia [Pick, 1924;Tamazaki, 1930;Wachstein, 1932]. The contrast is exemplified by the speed with which the sinus node reacts to ligation of its vessels, becoming paralysed in a few seconds (described by Rothberger and Scherf, 1927, and confirmed in an experiment of this series), as compared with the long latent period before the bundle or its branches cease to conduct impulses after ligation of the septal artery [Kahn, 1911;Lauterb ack, 1928].…”

Section: Interpretation Of Resultsmentioning

confidence: 99%

“…In contrast to the specific tissues of the sinus node and auriculo-ventricular node, which react promptly to oxygen lack [Lewis, White and Meakins, 1913;Rothberger and Scherf, 1927], it is an experimental fact that the conducting tissues in the ventricles are peculiarly resistant to anoxeemia [Pick, 1924;Tamazaki, 1930;Wachstein, 1932]. The contrast is exemplified by the speed with which the sinus node reacts to ligation of its vessels, becoming paralysed in a few seconds (described by Rothberger and Scherf, 1927, and confirmed in an experiment of this series), as compared with the long latent period before the bundle or its branches cease to conduct impulses after ligation of the septal artery [Kahn, 1911;Lauterb ack, 1928]. Purkinje tissue in vitro also will contract'in oxygenfree perfusion fluid [Wachstein, 1932], or in the presence of cyanide in concentrations enough to abolish tissue oxidation in other tissues [Pick, 1924;Tamazaki, 1930].…”

Section: Interpretation Of Resultsmentioning

confidence: 99%

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The effect of ligation of posterior coronary vessels on the electrocardiogram in experimental bundle‐branch block

Hill¹

1934

The Journal of Physiology

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IT has been reported by Averbuck and Rachmilewitz [1931] that in dogs in which the branches descending from the circumflex ramus of the left coronary artery on the posterior surface of the heart had been ligated, section of the right branch of the His bundle no longer gave electrocardiograms typical of bundle-branch block. It is of note that an anuscesophagus lead alone was employed, and that although section of the branch was performed sometimes before, sometimes after tying the vessels, the electrocardiographic observations were always made within a few minutes or at most an hour of the ligation. The authors discussed their results, which they admitted to be surprising, at some length, and came to the conclusion that the absence of the typical picture of branch block was due to interference with the blood supply of a part of the specific conducting tissue in the left ventricle, brought about by the coronary ligatures, and that their curves were comparable to those obtained by Rothberger and Winterberg [1917] after section of the right branch and posterior division of the left branch of the His bundle.During the course of an experimental study in which the writer was associated, carried out by Wilson and his co-workers on the results of coronary ligation in the dog, the opportunity was taken to repeat the section of the right branch in dogs with various infarcts Grout, 1933a, 1933c]. The section was made always after an interval of 36-48 hours from the time of ligature, and fairly

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Zur Kenntnis der Erregungsausbreitung vom Sinusknoten auf den Vorhof

Cited by 77 publications

References 12 publications

Inferior Interatrial Pathway in the Dog

Inferior Interatrial Pathway in the Dog

The Anatomic Basis of Connections Between the Coronary Sinus Musculature and the Left Atrium in Humans

The effect of ligation of posterior coronary vessels on the electrocardiogram in experimental bundle‐branch block

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