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[Surgery of the heart conduction system].

Problems concerned with surgery of the heart conduction system are discussed. Two operations performed directly on the heart conduction system are analysed: operation for dividing the bundle of His or Keith's node with subsequent implantation of electrocardiostimulators in ventricular tachycardia unresponse to drugs and operation for dividing the walls of the right atrium and interatrial septum leading to the development of atrioventricular rhythm. The incisions mentioned were used in approach to the mitral and tricuspid valves for their prosthetics. The second part of interventions on the heart conduction system involves surgical techniques aimed at avoiding damage to the conduction system in manipulations mainly on the cardiac septum. The author believes that this branch of cardiac surgery is new and promising.

Adult

[Methods of investigating the heart conduction system].

A description is presented of improved methods of examining the conductive system of the heart designed for special routine investigations. The methodology comprises: a) injection of coronary arteries with contrast medium and their X-ray visualization, b) special technique of heart postmortem, c) histological investigation with a view to the precise topography of the particular parts of the conductive system including detailed histological processing in series cestions by means of staining methods: haematoxylin-eosin, elastica-van Gieson, P. A. S., and Heidenhain.

Coronary Angiography

Cytoskeletal filaments of heart conducting system localized by antibody against a 55,000 dalton protein.

Cow heart conducting cells characteristically contain cytoplasmic intermediate-sized filaments. We report here the preparation of a specific antibody to a 55,000 dalton protein of isolated cow Purkinje fibres. Confirmation has been obtained that these filaments consist of the 55,000 dalton protein, using the indirect immunofluorescence technique. Cross-reaction is seen with vascular endothelium and smooth muscle cells of various origin, suggesting close identity of different types of intermediate-sized filaments.

Animals

[Morphology of the heart conduction system].

Using his own experience and literary research, the author gives an outline of the morphology of the conduction systems of normal children's and adult hearts, including its blood supply.

Adolescent

[Electron microscopic study of the innervation of the heart conduction system in rats].

A systemic quantitative electron microscopic analysis on innervation of the sinus node, the atrioventricular node, the bundle of His and its pedicles within the interventricular septum has been performed in intact hearts of mature rats. The data have been obtained on the size of nonmyelinated and myelinated nerve fibres, efferent and afferent terminals within different parts of the cardiac conductive system, their interconnection with specialized cardiomyocytes have been described. Application of certain methods for electron microscopic investigation on the innervation of mammalian cardiac conductive system has been discussed.

Animals

[Morphology of the principal divisions of heart conducting system of rats].

Light optic and electron microscopic investigation of the sinuauricular node node (spu), atrioventricular node (pzhu) and bundle of His (pzhp) has been carried out in 23 hearts of intact non-inbred male rats. Original techniques of oriented embedding of elements of the conductive system for their electron microscopic identification have been suggested. A morphological classification of specialized cardiac myocytes has been worked out basing on differences in their form and size, number of myofibrils and degree of their regulation. On its base three type of specialized myofibrils have been revealed in the conductive system. Topography of these cells has been described within spu, pzhu and pzhp. The suggested ultrastructural classification of specialized cardiac myocytes is compared with the data obtained for the cardiac conductive system in other types of mammals.

Animals

[Parameters of the bioelectrical activity of the heart conduction system in virtually healthy persons].

Intracardiac conduction was studied on the basis of the conception of the atrial spike potentials. Intracavitary electrograms were recorded from the right atrium, zone of the bundle of His, and the esophagus in 110 persons in 35 of whom no abnormalities were found in the heart and the results of the examination were accepted as control indices. On the grounds of the investigations conducted by them, the authors determined the shape, amplitude, and time of appearance of the spike potentials of the sinus rhythm, atria, and the bundle of His and also the duration of the intervals of intracardiac conduction. Study of the phenomena of bioelectric activization of the atria and the system of the bundle of His in a complex significantly widens the possibilities of selective assessment of disorders of intracardiac conduction at various levels of propagation of the stimulation.

Action Potentials

[State of the heart conduction system in the sick sinus syndrome (according to the recording of the bundle of His potentials and the atrial stimulation test)].

It was established that the presence of Samoilov-Wenckebach's periods and prolongation of the H--V interval at low frequency of the imposed rhythm as well as periods of asystolia of more than 1,200 msec are most typical for these patients. An attempt was made to determine the type of cardiac stimulation indicated for such patients from the character of the disorders of rhythm observed in them and the initial frequency of their own cardiac contractions.

Action Potentials

[Functional morphology of the heart conduction system in acute myocardial infarct].

The results of histochemical, histoenzymological, and fluorescence microscopy studies of the conductive tissue of the heart in acute myocardial infarction in 30 fatal cases are presented. Focal decrease in redox and hydrolytic enzymes, monoaminoxidase, and cholinesterase in elementa of the conduction system as well as changes in the pattern of fluorescence of the specific muscle cells were found. The intensity of metabolic lesions was more pronounced at early stages of myocardial infarction in those cases where the conducting pathways were proximal to the foci of necrosis.

Acid Phosphatase