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PubMedDate not supplied

[Study of the heart conduction system in atrioventricular disorders].

A His electrogram was registered with a Castillo tripolar catheter in seven patients with atrio-ventricular discordance and transposition of the great arteries (corrected transposition). They all had ventricular septal defect, six had pulmonary stenosis. two had atrial septal defect, and only one patient presented first degree AV block. The QRS was of normal duration, 4 had RBBB morphology in the left precordials. Two with ASD and VSD had a prolonged P/A interval. In one, the His recording was polyphasic with a prolonged H-V (55 msec) and two others showed a wide polyphasic His potential (25 and 26msec), with a prolonged H-V. These 3 cases with prolonged His had a minor degree of RBBB. The remaining 3 showed normal AV conduction. In all, the Purkinje electrogram was registered. The duration of the Pu potential and the Pu-V were normal. Corrected transposition shows a high incidence of slow AV conduction, frequently not detectable in the usual electrocardiogram in agreement with previous anatomo-pathological studies. The distal block would explain the frequency of complete AV block with low cardiac output and frequent sudden death in this type of heart disease. The distal block would compel us to take e more agressive steps in its treatment. Atrial septal defect with slowing of the intra-arial conduction is not detected in the electrocardiogram.

Electrocardiography↗
PubMed1988

[Dose-related effect of nicainoprol (CAS 924) on basic electrophysiologic parameters in patients with and without diseases of the heart conduction system].

The dose-dependent effects of nicainoprol (1 and 2 mg/kg/h), a new antiarrhythmic drug, on invasive electrophysiological parameters were evaluated in 28 patients during diagnostic electrophysiologic studies. The most pronounced effects by nicainoprol were observed on the specialized AV conduction system. The intranodal (1 mg/kg/h: A-H interval: 92 +/- 19 ms to 107 +/- 25 ms, p less than 0.002, n = 13; 2 mg/kg/h: 92 +/- 18 ms to 114 +/- 27 ms, p less than 0.001, n = 16) and, in particular, the infranodal conduction time (1 mg/kg/h: H-V interval: 45 +/- 5 ms to 52 +/- 9 ms, p less than 0.001, n = 15; 2 mg/kg/h: 45 +/- 6 ms to 58 +/- 10 ms, p less than 0.0001, n = 18) were delayed in a dose-dependent fashion. With the higher dose, there was a highly significant prolongation of the AV nodal Wenckebach cycle length (380 +/- 69 ms to 440 +/- 79 ms, p less than 0.0001, n = 13) as well as of the effective (368 +/- 112 ms to 428 +/- 108 ms, p less than 0.001, n = 12) and functional refractory periods (470 +/- 102 ms to 521 +/- 135 ms, p less than 0.001, n = 15). The intraatrial conduction time was slightly prolonged for both doses, the intraventricular conduction time increased significantly with the higher dose (89 +/- 12 ms to 102 +/- 19 ms, p less than 0.001, n = 19). In contrast, there were only small changes of right atrial and right ventricular refractorion.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Arrhythmia Agents↗
PubMed1976

[Embryonic histogenesis of the atrioventricular segment of the heart conduction system of swine (Sus porcus L.)].

Histological, histochemical and neurochemical methods were used in order to study the features of the histogenesis of structures of the atrioventricular area of the conducting system of the heart and the formation of their cholinergic innervation in the postnatal period of the hog. Under study were 175 hearts of embryos of the hog at the age of 3, 4, 5, 6, 8, 10, 12, 14 and 15 weeks and 22 hearts of adult hogs. The formation of different areas of this system was shown to be asynchronous. The atrioventricular fascicle is formed during the 4th week, the atrioventricular node -- during the 6th week and the conducting muscle fibres--during the 8th week of embryogenesis. The fascicle and the node have a complicated structure and different cellular composition. In the process of prenatal ontogenesis the increased amount of glycogen and increased activity of phosphorylase were noted in the cytoplasm of myocytes of the atrioventricular area of the conducting system of the heart. The cholinergic nerve fibres grow up to the structures of the atrioventricular area of the conducting system of the heart during the 6th week of embryogenesis, and by the end of the prenatal development they form a thick network in all its structures.

Animals↗
PubMed2005

Autoantibodies to human heart conduction system in Chagas' disease.

Destruction of heart tissue in chronic chagasic cardiopathy may be caused by autoimmune recognition of heart tissue. Indirect evidence suggests that there is antigenic cross-reactivity between Trypanosoma cruzi and heart tissue. The objective of this study was to determine whether seric autoantibodies against atrio-ventricular (AV) node and sinus auricular node tissues are markers of chronic cardiopathy condition. We searched for the presence of seric autoantibodies against AV node and sinus auricular node tissues in 25 sera from chronic chagasic cardiopathy patients, 20 sera from non-chagasic cardiopathy patients, 20 sera from indeterminate chagasic subjects, and 20 sera from healthy blood donors as controls. Diagnosis of dilated cardiopathy was established based on the left-ventricular end systolic dimension and cardiothoracic ratio on chest x-radiography and impaired contracting ventricle, and chagasic etiology by demonstration of circulating antibodies using ELISA and IIF. Autoantibody detection against conduction heart tissue was carried out by immunohistochemical test. The tissues were obtained from non-cardiopathy necropsy case. Human sera were diluted at 1:10 in PBS-FSB. Goat antihuman laminin was used as positive control. Autoantibodies were more frequently found in chronic chagasic cardiopathy (20%) compared to non-chagasic cardiopathy (5%) and indeterminate chagasic subjects (5%), pattern staining define interstitial and membrane targets on rich conduction system tissue. In conclusion seric autoantibodies against heart conduction system are not a good markers for chagasic cardiopathy group. Their presence showed no clear association with complex rhythm/conduction aberrations.

Animals↗
PubMed1981

[Changes in the heart conduction system in sudden cardiac death].

The conductive system of the heart was studied morphometrically in serial sections in 12 autopsy observations of sudden cardiac death. In 11 cases the sudden death was due to chronic ischemic disease of the heart, in 1 case to idiopathic myocarditis of Abramov-Fidler. The control consisted of 12 autopsy observations of subjects dying of mechanical trauma, alcoholic toxicity, cerebral hemorrhage in the presence of hypertension. In 4 out of 12 observations of sudden cardiac death, acute dyscirculatory disorders of the microcirculatory bed and focal destructive changes of specific muscle fibers were detected in the conductive system of the heart. The intensity of atrophic and sclerotic processes in ganglions of the conductive system was not significantly different from that in the controls.

Adult↗
PubMed1990

[Status of the heart conduction system in patients with epileptic seizures].

Diagnostic computer-aided transesophageal cardiac pacing was used to examine 45 patients with epileptic seizures of different genesis, who had no signs of cardiac rhythm derangement. 28 patients with heart arrhythmias and 30 practically healthy persons served as control groups. 64.44% of the patients with epileptic seizures manifested different types of latent pathology in the heart conduction system. Among the practically healthy persons, the analogous parameter was 10%, with premature heart beats being recorded only in single cases. 60.71% of the control group patients with heart arrhythmias showed alterations of the epileptic type demonstrated by the EEG. It is concluded that there is a close relationship between the epileptic process and pathology of the heart conduction system. Of definite role in this chain is the factor of the focal nature of the epileptic impairment, particularly the involvement of the ++temporo-diencephalic structures and ++limbico-reticular complex.

Adolescent↗
PubMed1998

[Dynamics of electrophysiological parameters of the heart conduction system in patients with alcoholism during long-term therapeutic-vocational rehabilitation].

Transesophageal pacing in 48 patients with alcoholism stage II made before, during and after long-term rehabilitation has shown that initial electrophysiological parameters of the heart conductive system were impaired. In alcoholics who have abused alcohol for less than 10 years rehabilitation brought about positive changes from month 3 to 24 of alcohol withdrawal. Initially registered paroxysmal tachyarrhythmia was eliminated. In longer duration of alcoholism functional recovery of conductive system of the heart was not complete.

Adolescent↗
PubMed1989

[Functional status of the heart conduction system and myocardial contractility in patients with alcoholic heart damage].

33 patients with alcoholic heart damage (AHD) were studied. The diagnosis was based on clinical symptoms of chronic alcoholism, roentgenocontrast coronaroangiography and ventriculography (in some cases with endomyocardial biopsy), echocardiography, bicycle exercise test and on exclusion of other cardiovascular diseases. In all the patients intracardiac electrophysiological study was performed. Younger persons systematically abusing alcohol and having no pronounced clinical picture of cardiovascular damage exhibited symptoms of functional conduction disturbances located mainly in ventricular conduction pathways and AV-node and more rarely in the sinus node and His-Purkinje's system. AHD in younger persons could have 2 different clinical courses. 1) with prevailing damage in conductive structures; 2) with prevailing damage of contractile myocardium.

Adult↗
PubMed1996

[Changes in the heart conduction system in a case of Wegener's granulomatosis].

Since the initial description by Klinger in 1931 and confirmation by Wegener in 1936, Wegener's granulomatosis has emerged as an uncommon disease entity of unknown aetiology. This disease is characterized by a granulomatous-necrotizing general vasculitis, which most frequently affects the respiratory tract, and by a usually focal necrotizing glomerulonephritis. We report one case of Wegener's granulomatosis with reference to heart conduction system involvement and to nervous plexuses localized in the heart. Specialized conduction system of the heart is little investigated in Wegener's granulomatosis. The blocks of tissue containing the sinoatrial node, the atrio-ventricular node, His bundle, the bifurcation and both bundle branches were fixed in buffered formalin 10% and embedded in paraffin, cut serially at 150 mu intervals and stained alternately with hematoxylin-eosin and Heidenhain trichromic (azan). This heart showed fibrosis near distal His bundle, coronaric arteriolar severe stenosis and fibrotic involvement of the root of the left branch. This histological picture is plausibly and result of scarring of arteriolar specific granulomatous process, also in relation to the low grade of coronarosclerosis. Sclerosis of specific conduction tissue, in addition to cardiac intramural arteriolar subocclusion and to aspecific inflammation of nervous plexuses, can be considered as a plausible arrhythmogenic base of death.

Granulomatosis with Polyangiitis↗
PubMed1995

[Discovery of the pacemaker and heart conduction system in mammals. Fantasy and truth].

The first report about experimental investigations on the origin of the rhythms in the mammalian heart were published in 1888 by McWilliam. Similar experiments were described by Hering in several publications starting from 1900. The results led to the hypothesis of the myogenic genesis of the rhythms. However, in 1907, Hering stated that the origin of the stimulus in the mammal heart was probably a nervous function. In 1898, 1903, and 1906 Wenckebach described the function and the functional localization of the pacemaker in the heart of the intact man, and in 1906, he described the morphology of the pacemaker and its blood supply in the post mortem human heart. In the same year, Adam analyzed the localization of the "natural" pacemaker and the regions of the secondary pacemakers in the mammal heart. In 1907, Keith and Flack introduced the term "sino-auricular node". They quoted the findings of Wenckebach and Hering, and they mentioned McWilliam. A muscular connection between the right atrium and both ventricles of the mammal heart was found by Kent and by His in 1893. In 1907, Tawara called the structure of the origin of the a-v connection "atrio-ventricular node". It was, however, the scientific discovery of Tawara that the a-v pathway was connected with the muscles of the ventricles by the Purkinje fibers. He discovered that the pathway consists of muscles which are histologically divided and functionally different from the other heart muscles. It is a system of specialized muscles which conduct the stimulus for the contraction without contracting themselves.

Animals↗
PubMedDate not supplied

[Changes in central hemodynamics and the heart conduction system during total intravenous anesthesia using diprivan in extensive abdominal surgery].

Diprivan was included in the multicomponent intravenous anesthesia during extensive prolonged and traumatic operations in abdominal surgery and gynecology. The investigations showed the minimal effect of anesthesia with diprivan, diazepam, and phentanyl on the central hemodynamics and conducting system of the heart. The suggested anesthetic scheme may be a method of choice in patients at a high risk of surgical anesthesiological injury.

Abdomen↗