Document Detail


Migration of the true pacemaker within the sinoatrial cell aggregate in man.
MedLine Citation:
PMID:  1487935     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The functional anatomy of the sinoatrial node (SAN) in man is first reviewed, together with its possible anatomical substructure. The true group pacemaker (PM) shift under autonomic drive is then related to a continuous competition between the intrinsic auto-firing period hierarchy and the autonomic topological susceptibility hierarchy. Accordingly, the PM 'skip' to both lower and higher periods following an abrupt and consistent acetylcholine (ACh) release at the SAN periphery, and the PM 'slip' towards a relocation of the next period, as a possible response to a slower and smaller ACh release, are considered. The PM 'skip' and 'slip' as boundaries of the true PM excursion within the SAN during the respiratory cycle, and their statistical properties, are then examined. Under current heart rate control menus in normals, the PM skip appears to follow central influence, whereas the conservative or slipping PMs suggest peripheral control. Finally, interpretation of the PM skip as a salutary sign of functional reserve is proposed, and a method of alleviating the PM skip which confounds electrophysiological testing of the SAN function in patients is devised.
Authors:
R M Negoescu
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Medical & biological engineering & computing     Volume:  30     ISSN:  0140-0118     ISO Abbreviation:  Med Biol Eng Comput     Publication Date:  1992 Jul 
Date Detail:
Created Date:  1993-02-22     Completed Date:  1993-02-22     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7704869     Medline TA:  Med Biol Eng Comput     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  CE42-8     Citation Subset:  IM    
Affiliation:
Cardiovascular Training Laboratory, Ramatuelle, France.
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MeSH Terms
Descriptor/Qualifier:
Arrhythmia, Sinus / physiopathology
Biological Clocks / physiology*
Electrophysiology
Humans
Sinoatrial Node / physiology*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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