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Anatomic Assessment of Variations in Myocardial Approaches to the Atrioventricular Node.
MedLine Citation:
PMID:  22050028     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Atrial Septum, Coronary Sinus, and Atrioventricular Node. Introduction: The tissues in the posteroinferior atrioventricular (AV) junction around the AV node are important in procedures for ablating and manipulation of catheters in and around the coronary sinus (CS). However, information with regard to the histological arrangement of perinodal myocardium relative to the CS is lacking. Methods and Results: We examined 21 postmortem human hearts without any abnormalities (9 women; mean age 68.8 ± 14.3 years). After making measurements, the posteroinferior AV junction was removed and processed for histology. Sections were cut parallel to the septum. We assessed the myocardial arrangements from the atrial septum and the CS toward the AV nodal tissue, including the transitional cell zone, and measured the dimensions between the compact AV node and the CS, and the circumference of the CS. We observed 3 patterns of myocardial approaches to the AV node: extension of myocardium from the atrial septum (Group A; n = 6); extension of CS musculature (Group B; n = 6); and both septal and CS musculature (Group C; n = 9). The distance between the AV node and the CS in Group A was significantly longer than in the other groups (mean 11.5 ± 3.1 mm, 1.7 ± 0.6 mm, 3.8 ± 1.5 mm, respectively; P < 0.0001), and the circumference of the CS in Group B was longer than in Group A (mean 31.1 ± 7.9 mm*, 44.4 ± 8.4 mm*, 33.7 ± 6.9 mm, respectively; P < 0.05). Conclusion: The myocardial approaches including the transitional cell zone toward the AV node are variable in normal hearts. The location and size of the CS can affect the myocardial arrangements and the area of transitional cells around the AV node. (J Cardiovasc Electrophysiol, Vol. pp. 1-6).
Authors:
Taka-Aki Matsuyama; Siew Yen Ho; Karen P McCarthy; Akiko Ueda; Hisaki Makimoto; Kazuhiro Satomi; Shiro Kamakura; Shin Inoue; Hatsue Ishibashi-Ueda
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-3
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  -     ISSN:  1540-8167     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-4     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2011 Wiley Periodicals, Inc.
Affiliation:
Cardiac Morphology Unit, Royal Brompton Hospital, National Heart and Lung Institute, Imperial College London, London, UK Division of Arrhythmia and Electrophysiology, Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan Department of Internal Medicine, Showa University Dental Hospital, Tokyo, Japan Department of Pathology, National Cerebral and Cardiovascular Center, Suita, Japan.
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