The Human Pacemaker and Its Pathology

Hudson, Reginald E. B.

doi:10.1136/hrt.22.2.153

Cited by 113 publications

(41 citation statements)

References 8 publications

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“…At the macroscopic level, in our study, the sinus node was indiscernible to the naked eye observation of the right atrium at the cavoatrial junction as demonstrated by Reginald Hudson [8] in 1960. However, the wall thickening, observed at the endocardial surface of the sinus node area and the sinus node artery found to the naked eye in this area, are not described in the literature, they could be considered significant indirect signs of the presence of sinus node.…”

Section: Discussionmentioning

confidence: 89%

“…Our method has similarities to that used by some authors such as Reginald Hudson [8] in 1960, Davies [9] in 1972 and Kenneth Anderson [10] in 1979, all in Britain, which after removal of the sinoatrial node, made vertical cuts for the first two, and mixed, vertical and cross-sections for the last.…”

Section: Discussionmentioning

confidence: 97%

“…The atrial incision may divide it; the superior vena caval tourniquet may damage it; it may be crushed by forceps; or it may be involved in suturing [8]. After orthotopic heart transplantation by standard biatrial anastomosis, the atrial surgery which involves substantial incision and suturing of the donor's anterior right atrial wall has the potential to disturb the sinus node and produce an arrhythmogenic substrate [16].…”

Section: Discussionmentioning

confidence: 99%

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Location of the Human Sinus Node in Black Africans

Gc¹,

Kh²,

Abro³

et al. 2017

Anat Physiol

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Objective: The purpose of this study was to describe, in 45 normal hearts of black Africans adults, the location of the sinoatrial node. Methods:After naked eye observation of the external epicardial area of the sinus node classically described as cavoatrial junction (CAJ), a histological study of the sinus node area was performed.Results: This study concluded that the sinus node is indistinguishable to the naked eye (97.77% of cases), but still identified histologically at the CAJ in the form of a cluster of nodal cells surrounded by abundant connective tissues. It is distinguished from the Myocardial Tissue. Conclusion:The sinus node is located in the cavoatrial junction but, most often, indistinguishable to the naked eye. Therefore, this area should be avoided during cardiac surgery.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

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Location of the Human Sinus Node in Black Africans

Gc¹,

Kh²,

Abro³

et al. 2017

Anat Physiol

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“…It has been shown that there is clear evidence in the human atrial myocardium of age-related electrical uncoupling of the side-to-side connections between bundles. This is histologically related to the proliferation of extensive collagenous tissue septa in intracellular spaces [4][5][6]. In pathological studies, it was demonstrated that these age-induced changes include a reduction in the number of myocardial cells within the sinus node, a generalized loss of atrial myocardial fibers, as well as an increase in fibrosis which leads to an apparent loss of myocardial fiber continuity [1][2][3][4][5][6].…”

Section: Editorialmentioning

confidence: 99%

P Wave Duration and Dispersion as a Useful Conventional Electrocardiographic Marker for Atrial Fibrillation Prediction

2017

JCCR

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“…1 Muscle loss with advancing age was found to be accompanied by an increase in fibrous tissue in both the sinoatrial node and the internodal tracts. [2][3][4] It was strongly suggested that muscle loss and increase of fibrosis in the atria is a slow but continuous process starting at about 60 years of age. 3 Since aging has a profound effect on structural changes of the atrial muscle, and since fractionated atrial endocardial electrograms may reflect nonsynchronized, delayed local electrical activity through a diseased atrial muscle, 5 it seems reasonable to assume that there may be detectable age-induced changes in atrial endocardial electrograms in patients with paroxysmal atrial fibrillation (PAF).…”

Section: Introductionmentioning

confidence: 99%

The effects of aging on atrial endocardial electrograms in patients with paroxysmal atrial fibrillation

Centurión

Isomoto

Shimizu

et al. 2003

Clinical Cardiology

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Background: The prevalence of atrial fibrillation (AF) has been reported to increase with advancing age. Histologic studies in AF have demonstrated that the percentage of fibrosis and degenerative changes in the atrial muscle increase significantly with age. Hypothesis: This study was undertaken to assess the influence of advancing age on atrial endocardial electrograms recorded during sinus rhythm in patients with paroxysmal atrial fibrillation (PAF), which had not been assessed previously. Methods: Right atrial endocardial catheter mapping during sinus rhythm was performed in 111 patients with PAF to evaluate the influence of advancing age onatrial endocardial electrograms. The bipolar electrograms were recorded at 12 sites in the right atrium, and an abnormal atrial electrogram was defined as lasting ≥ 100 ms, and/or showing eight or more fragmented deflections. Results: In all, 1,332 right atrial endocardial electrograms were assessed and measured quantitatively. The number of abnormal atrial electrograms in patients with PAF showed a significantly positive correlation with age (r = 0.34; p<0.0005). Patients aged > 60 years had a significantly greater mean number of abnormal electrograms (2.58 ± 2.05) than those aged < 60 years (1.43 ± 2.03; p<0.004). The longest duration (r = 0.35; p<0.0005) and the maximal number of fragmented deflections (r = 0.29; p<0.005) of atrial electrograms among the 12 right atrial sites also showed a significantly positive correlation with age. Conclusions: Aging alters the electrophysiologic properties of the atrial muscle in patients with PAF. Elderly patients have a significantly greater abnormality of atrial endocardial electrograms than do younger ones. There is a progressive increment in the extension of altered atrial muscle with advancing age in patients with PAF.

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The Human Pacemaker and Its Pathology

Cited by 113 publications

References 8 publications

Location of the Human Sinus Node in Black Africans

Location of the Human Sinus Node in Black Africans

P Wave Duration and Dispersion as a Useful Conventional Electrocardiographic Marker for Atrial Fibrillation Prediction

The effects of aging on atrial endocardial electrograms in patients with paroxysmal atrial fibrillation

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