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Impulse propagation from the SA-node to the ventricles
Authors:F. I. M. Bonke  C. J. H. J. Kirchhof  M. A. Allessie  A. L. Wit
Affiliation:(1) Dept. of Physiology, Biomedical Center, University of Limburg, P.O. Box 616, NL-6200 MD Maastricht, (The Netherlands);(2) Rockefeller University, New York, New York, USA
Abstract:Summary Normally the pacemaker of the mammalian heart is located in the sinus node. In the rabbit the sinus node can be subdivided into two regions, the center of the node where the impulse originates and the border zone through which the impulse is conducted towards the atrium. Conduction properties of both regions were investigated. It appeared that conduction velocity increases and refractoriness decreases when one goes from the nodal center towards the atrium. The tissue mass of the atrium is large in comparison to the sinus node and normally the resting membrane potential of atrial fibers is more negative than that of nodal fibers; consequently, a potential difference exists causing a current flow between both areas. Evidently this hyperpolarizing current flow depresses impulse formation in the border zone fibers which have better intrinsic pacemaker properties than fibers in the nodal center. If the impulse has reached the atrium it is conducted with a relatively high safety factor and will reach the AV node in principle without difficulty. The AV node, if deprived of sinus nodal dominance, develops spontaneous activity originating from the lower nodal fibers. Also in this structure, electrotonic depression by surrounding tissue causes deceleration of the pacemaker.
Keywords:Sinus node  nodal impulse conduction  AV node  impulse formation  electrotonic influence
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