|
|
||||||||
Department of Cardiology, Cleveland Clinic Foundation, Cleveland, OH 44195
The following is an abstract of the article discussed in the subsequent letter:
Choi, Bum-Rak, and Guy Salama. Optical
mapping of atrioventricular node reveals a conduction barrier between atrial and nodal cells. Am. J. Physiol. 274 (Heart Circ.
Physiol. 43): H829-H845, 1998.
The mechanisms
responsible for atrioventricular (AV) delay remain unclear, in part due
to the inability to map electrical activity by conventional
microelectrode techniques. In this study, voltage-sensitive dyes and
imaging techniques were refined to detect action potentials (APs) from
the small cells comprising the AV node and to map activation from the
"compact" node. Optical APs (124) were recorded from 5 × 5 mm (~0.5-mm depth) AV zones of perfused rabbit hearts stained with a
voltage-sensitive dye. Signals from the node exhibited a set of three
spikes; the first and third (peaks I
and III) were coincident with atrial (A) and ventricular (V) electrograms, respectively. The second spike
(peak II)represented the firing of
midnodal (N) and/or lower nodal (NH) cell APs as indicated by
their small amplitude, propagation pattern, location determined from
superimposition of activation maps and histological sections of the
node region, dependence on depth of focus, and insensitivity to
tetrodotoxin (TTX). AV delays consisted of
1 (49.5 ± 6.59 ms, 300-ms
cycle length), the interval between peaks
I and II (perhaps AN
to N cells), and
2 (57.57 ± 5.15 ms), the interval between peaks
II and III (N to V
cells). The conductance time across the node was 10.33 ± 3.21 ms,
indicating an apparent conduction velocity
(
N) of 0.162 ± 0.02 m/s
(n = 9) that was insensitive to TTX.
In contrast,
1 correlated with
changes in AV node delays (measured with surface electrodes) caused by
changes in heart rate or perfusion with acetylcholine. The data provide
the first maps of activation across the AV node and demonstrate that
N is faster than previously presumed. These findings are inconsistent with theories of decremental conduction and prove the existence of a conduction barrier between the
atrium and the AV node that is an important determinant of AV node delay.
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| Visit Other APS Journals Online |