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Conduction System Tutorial
Overview of Cardiac Conduction Control of Ones Heart Rate Cardiac Action Potentials Gap Junctions Atrioventricular Node and Bundle of His Summary and References


This tutorial reviewed the basic architecture and function of the cardiac conduction system in order to provide the reader with a working knowledge and pertinent vocabulary associated with this topic. While a great deal of literature exists regarding the cardiac conduction system, numerous questions remain related to the detailed histological anatomy and cellular physiology of these specialized conduction tissues and how they become modified in disease states. Future findings associated with the function and anatomy of the cardiac conduction system will likely lead to improvements in therapeutic approaches and medical devices.


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  3. Racker DK, Kadish AH. Proximal atrioventricular bundle, atrioventricular node, and distal atrioventricular bundle are distinct anatomic structures with unique histological characteristics and innervation. Circulation 2000; 101:1049-59.
  4. Furman S. A brief history of cardiac stimulation and electrophysiology - the past fifty years and the next century. NASPE Keynote Address, 1995.
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  10. Yamamoto M, Dobrzynski H, Tellez J, et al. Extended atrial conduction system characterised by the expression of the HCN4 channel and connexin45. Cardiovasc Res 2006; 72:271-81
  11. Betts TR, Roberts PR, Ho SY, et al. High density mapping of shifts in the site of earliest depolarization during sinus rhythm and sinus tachycardia. PACE 2003; 26:874-82.
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  16. Waller BF, Gering LE, Branyas NA, et al. Anatomy, histology, and pathology of the cardiac conduction system: Part I. Clinical cardiology 1993; 16:249-52.
  17. Boyett MR, Honjo H, Kodama I, et al. The sinoatrial node: cell size does matter. Circ Res 2007; 101:e81-2.
  18. Garson AJ, Bricker JT, Fisher DJ, Neish SR, editors. The Science and Practice of Pediatric Cardiology. Volume I. Baltimore, MD: Williams & Williams, 1998:141-3.
  19. Li JL, Greener ID, Inada S, et al. Computer three-dimensional reconstruction of the atrioventricular node. Circ Res 2008; 102:975-85.
  20. Yin L, Laske TG, Rakow N, et al. Intracardiac echocardiography-guided his bundle pacing and atrioventricular nodal ablation. Pacing Clin Electrophysiol 2008; 31:536-42.
  21. Becker AE, Anderson RH. The morphology of the human atrioventricular junctional area. In: Wellens HJJ, Lie KI, Janse MJ, editors. The conduction system of the heart: structure, function, and clinical implications. Philadelphia, PA: Lea & Febiger, 1976:263-86.
  22. Aschoff L. Referat uber die herzstorungen in ihren bezeihungen zu den spezifischen muskelsystem des herzens. Verh Dtsch Ges Pathol 1910; 14:3-35.
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  24. Hucker WJ, McCain ML, Laughner JI, et al. Connexin 43 expression delineates two discrete pathways in the human atrioventricular junction. Anat Rec 2008; 291:204-15.
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Additional Reference Texts

  • Mohrman DE, Heller LJ. Cardiovascular Physiology, fifth edition. New York: Langer Medical Books/McGraw-Hill, 2003.
  • Wellens HJJ, Lie KI, Janse MJ. The Conduction System of the Heart: Structure, Function, and Clinical Implications. Philadelphia: Lea & Febiger, 1976.
  • Sigg DS, Iaizzo PA, Xiao Y-F, He B (Editors) Cardiac Electrophysiology Methods and Models, Springer, Inc. 2010.
  • Alexander RW, Schlant RC, Fuster V. Hurst's: The Heart: Arteries and Veins, ninth edition. New York: McGraw-Hill, 1998.
  • Katz AM. Physiology of the Heart, third edition. Philadelphia: Lippincott, Williams, and Wilkins, 2001.
  • Tortora GJ, Grabowski SR. Principles of Anatomy and Physiology, ninth edition. New York: John Wiley & Sons, Inc., 2000.
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