Document Detail

The morphology of the specialized atrioventricular junctional area: the evolution of understanding.
MedLine Citation:
PMID:  12137349     Owner:  NLM     Status:  MEDLINE    
Although knowledge of its existence has barely exceeded one century, the anatomic pathway for conduction of the cardiac impulse from atria to ventricles has been the source of much controversy, controversy that continues to the present day. This article describes how attention to the original descriptions, along with adherence for sensible definitions for the histological distinction of conduction tissues, could have defused many of these disagreements. One of the problems with the initial descriptions was that they were written in German. Even this is no longer a problem, since the major text devoted to the topic has recently been translated into English, and is now available for all to study. This key work was the monograph produced by Sunao Tawara, a Japanese pathologist who studied in the first decade of the 20th century in the laboratory of Ludwig Aschoff. Tawara showed that the atrial impulse was conducted to the ventricular myocardium by a solitary pathway of specialized myocardium. He likened this pathway to a tree, with its roots in the base of the atrial septum, and its branches straddling the crest of the muscular ventricular septum. Significantly, he showed that the pathway became insulated as it crossed from atrial to ventricular musculatures, and suggested that the point at which the muscle became engulfed in fibrous tissue should be taken as the boundary between the "knoten," or atrioventricular node, and the penetrating bundle described earlier by Wilhelm His. The authors' findings are entirely compatible with the account given by Tawara. Like Tawara, they recognize atrial transitional cells, a compact node, the penetrating bundle, and the ventricular conduction pathways as the segments of the conduction axis which can be considered to represent the specialized atrioventricular junction.
Robert H Anderson; Siew Yen Ho
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  25     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-07-24     Completed Date:  2003-02-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  957-66     Citation Subset:  IM    
Cardiac Unit, Institute of Child Health, University College, London, United Kingdom.
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MeSH Terms
Atrioventricular Node / anatomy & histology*,  physiology
Bundle of His / anatomy & histology*,  physiology
Heart / anatomy & histology*
Heart Conduction System / anatomy & histology*,  physiology

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

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