Evaluation of a simplified method of the conduction system analysis in 110 forensic cases

The relationship between electrical axis by 12-lead electrocardiogram and anatomical axis of the heart by cardiac magnetic resonance in healthy subjects

“…It has been shown that there is a considerable variation in the architecture of the distal conduction system (27). Furthermore, the stronger age-dependence of electrical axis than of anatomical axis found in the frontal plane in present study, might partly be explained by increased fibrosis and fatty infiltration in the conduction system with increased age (28).…”

Evaluation Of Cardiac Conduction System In Sudden Deaths

“…We think that it may be a result of the differences between the regional dietary habits as well as the higher average age in our study (2,(12)(13)(14)28 (12,13,18,29 (4,13,(30)(31)(32)(33)(34) (14,21,(42)(43)(44) (2,13,16,26,27,46 …”

“…(2,13,14,(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27) Grade I (+): Irregular widening of the myofibrils or small amounts of fibrosis, adipose tissue infiltration less than 25%, random mono nuclear cellular accumulation.…”

Is there progress in the autopsy diagnosis of sudden unexpected death in adults?

“…In some of the cases, very focal heart abnormalities can be overlooked if no conduction system analysis is performed. Recent publications underlined the importance of systematic conduction system analysis in sudden adult death, with new simplified and time-efficient methods introduced for forensic routine practice [25,26], allowing the detection of major abnormalities such as severe narrowing (75%) of the atrioventricular node (AVN) artery due to fibromuscular hyperplasia (FMH) and atrioventricular node tumors. As FMH of the AVN artery has been found in control cases, it is a legitimate cause of sudden death (the mechanism is AVN ischemia) when other causes are excluded, especially if there is a severe artery narrowing (75%) and disruption of the internal elastic lamina.…”