In the words of Dr. Douglas Zipes, "the AV [atrioventricular] node is the 'soul" of the heart, and whoever understands its anatomy and electrophysiology will unlock the key to understanding the anatomical and electrical workings of the heart itself. This book reviews what we know and do not know about the AV node, and as such, serves as a good road map in our search for that elusive key." The book is divided into two parts, basic and clinical. The basic chapters discuss the fundamentals of AV nodal anatomy and morphology in the normal and diseased heart, the principles of slow conduction, the functional property of the transmission through the AV node, its cellular electrophysiology, its control by the autonomic nervous system as well as its behavior and participation in arrhythmias such as atrial fibrillation.The clinical chapters are devoted to a wide array of problems, including the clinical pharmacology of the AV nodal conduction, slow and fast pathway ablation in AV nodal reentrant tachycardia, unusual electrophysiology of the human AV node in relation to AV nodal reentrant tachycardia, AV nodal modification and/or ablation for control of ventricular rate during atrial fibrillation, and the effects of radiofrequency ablation on autonomic regulation of the AV node.
Renowned specialists from around the globe share their different, sometimes controversial, opinions on these subjects, thus giving the reader the opportunity to evaluate the current knowledge through the experience of different schools.This book was written to serve as an important source of information for cardiologists, electrophysiologists, anatomopathologists, biophysicists, and biomedical engineers. The authors believe it will be useful "both for those that remember the growth of our knowledge in the past (20th) century, and for those that will finally be able to resolve the remaining mysteries in the next."
From the EditorsForewordLeonard S. DreifusIntroductionDouglas P. Zipes ContributorsPart I. Anatomy and Basic Electrophysiology of the AV Nodal ConductionChapter 1. The Atrial Connections of the Specialized Axis Responsible for AV ConductionRobert H. Anderson and Siew Yen HoChapter 2. Anatomic-Morphologic Relations Between AV Nodal Structure and Function in the Normal and Diseased HeartSaroja BharatiChapter 3. Historical Perspective of Studies on Impulse Formation and Conduction in the AV NodeYoshio Watanabe and Tadayoshi HataChapter 4. Principles of Slow Conduction in Cardiac Tissue: Mathematical ModelingYoram RudyChapter 5. Principles of Slow and Discontinuous Conduction: Experimental ObservationsAndre G. Kleber, Jan P. Kucera, and Stephan RohrChapter 6. Spatial Distribution of Ion Channels, Receptors, and Innervation in the AV NodeKevin Petrecca and Alvin ShrierChapter 7. Distribution and Function of Gap Junction Proteins in Atrial-AV Nodal ConductionJeffrey E. Saffitz, Kathryn A. Yamada, and Richard B. SchuesslerChapter 8. Cellular Pharmacology of AV Nodal Conduction and AutomaticityTadayoshi Hata and Yoshio WatanabeChapter 9. Mechanisms of Vagosympathetic Control of the Atrial-AV Nodal ConductionDon W. Wallick, Sherry L. Stuesse, and Matthew N. LevyChapter 10. Functional Properties of the AV Node: Characterization and Role in Cardiac RhythmsJacques Billette and Farid AmellalChapter 11. Is the Atrium Involved in AV Nodal Reentry?Michiel J. Janse, Peter Loh, and Jacques M.T. de BakkerChapter 12. What is the Slow AV Nodal Pathway?Mark A. McGuireChapter 13. The AV Conjunction: A Concept Based on Ablation Techniques in the Normal HeartBenjamin J. Scherlag, Eugene Patterson, William Yamanashi, Warren M. Jackman, and Ralph LazzaraChapter 14. The AV Nodal Dual Pathway Electrophysiology: Still a Controversial ConceptTodor N. Mazgalev and Patrick J. TchouChapter 15. Autonomic Modulation of AV Nodal ConductionJosef Kautzner, Marek Malik, and A. John CammChapter 16. AV Node Function During Atrial Fibrillation Frits L. Meijler and Jose JalifeChapter 17. Role of the AV Nodal Inputs for Modulation of the Ventricular Rate During Atrial FibrillationStephane X. Garrigue and Todor N. MazgalevChapter 18. Fluorescent Imaging of Electrical Activity in the AV Node of Rabbit HeartIgor R. Efimov and Todor N. MazgalevPart II. Clinical Electrophysiology of the AV Nodal ConductionChapter 19. Clinical Pharmacology of AV Nodal ConductionJohn P. DiMarco and Michael DruckerChapter 20. Remodeling of the Atria During Atrial FibrillationDavid R. van Wagoner, Jeanne M. Nerbonne, and Albert L. WaldoChapter 21. Dual Atrionodal Physiology in the Human HeartSteven M. Markowitz, Kenneth M. Stein, Suneet Mittal, and Bruce B. LermanChapter 22. Electrocardiographic Manifestations of Dual AV Nodal Conduction During Sinus RhythmCharles FischChapter 23. Slow And Fast Pathway Ablation in AV Nodal Reentrant Tachycardia: Anatomic Approaches and Pathway PotentialsMichel Haissaguerre, Dipen C. Shah, Pierre Jais, Atsushi Takahashi, Meleze Hocini, Stephane Garrigue, and Jacques ClementyChapter 24. Unusual Electrophysiology of the Human AV Node in Relation to AV Nodal Reentrant Tachycardia. Part I: Multiple AV Nodal Pathways. Part II: Continuous AV Nodal Function CurvesShih-Ann Chen, Ching-Tai Tai, Chern-En Chiang, and Mau-Song ChangChapter 25. The Reentry Circuit for Slow/Fast AV Nodal Reentrant TachycardiaKenichiro Otomo, Zulu Wang, Karen J. Beckman, Peter Spector, Hiroshi Nakagawa, Kagari Matsudaira, Eugene Patterson, Ralph Lazzara, and Warren M. JackmanChapter 26. Autonomic Effects on the Human AV NodeEric N. PrystowskyChapter 27. AV Nodal Modification for Ventricular Rate Control of Atrial FibrillationAllan C. Skanes, Andrew D. Krahn, Raymond Yee, and George J. KleinChapter 28. AV Node Ablation for Ventricular Rate Control of Atrial FibrillationChristopher R. Cole and Mina K. ChungChapter 29. Autonomic Effects of Radiofrequency Catheter AblationMary R. Olsovsky and Kenneth A. Ellenbogen Index