دورية أكاديمية
أعرض في EDS

Three-dimensional functional anatomy of the human sinoatrial node for epicardial and endocardial mapping and ablation.

التفاصيل البيبلوغرافية
العنوان: Three-dimensional functional anatomy of the human sinoatrial node for epicardial and endocardial mapping and ablation.
المؤلفون: Kalyanasundaram A; Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus, Ohio; Bob and Corrine Frick Center for Heart Failure and Arrhythmia, The Ohio State University Wexner Medical Center, Columbus, Ohio., Li N; Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus, Ohio; Bob and Corrine Frick Center for Heart Failure and Arrhythmia, The Ohio State University Wexner Medical Center, Columbus, Ohio., Augostini RS; Bob and Corrine Frick Center for Heart Failure and Arrhythmia, The Ohio State University Wexner Medical Center, Columbus, Ohio; Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio., Weiss R; Bob and Corrine Frick Center for Heart Failure and Arrhythmia, The Ohio State University Wexner Medical Center, Columbus, Ohio; Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio., Hummel JD; Bob and Corrine Frick Center for Heart Failure and Arrhythmia, The Ohio State University Wexner Medical Center, Columbus, Ohio; Division of Cardiovascular Medicine, The Ohio State University Wexner Medical Center, Columbus, Ohio., Fedorov VV; Department of Physiology & Cell Biology, The Ohio State University Wexner Medical Center, Columbus, Ohio; Bob and Corrine Frick Center for Heart Failure and Arrhythmia, The Ohio State University Wexner Medical Center, Columbus, Ohio. Electronic address: vadim.fedorov@osumc.edu.
المصدر: Heart rhythm [Heart Rhythm] 2023 Jan; Vol. 20 (1), pp. 122-133. Date of Electronic Publication: 2022 Sep 14.
نوع المنشور: Journal Article; Review; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: Elsevier Country of Publication: United States NLM ID: 101200317 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1556-3871 (Electronic) Linking ISSN: 15475271 NLM ISO Abbreviation: Heart Rhythm Subsets: MEDLINE
أسماء مطبوعة: Original Publication: New York, NY : Elsevier, c2004-
مواضيع طبية MeSH: Sinoatrial Node* , Atrial Fibrillation*, Humans ; Heart Conduction System/physiology ; Vena Cava, Superior ; Heart Atria
مستخلص: The sinoatrial node (SAN) is the primary pacemaker of the human heart. It is a single, elongated, 3-dimensional (3D) intramural fibrotic structure located at the junction of the superior vena cava intercaval region bordering the crista terminalis (CT). SAN activation originates in the intranodal pacemakers and is conducted to the atria through 1 or more discrete sinoatrial conduction pathways. The complexity of the 3D SAN pacemaker structure and intramural conduction are underappreciated during clinical multielectrode mapping and ablation procedures of SAN and atrial arrhythmias. In fact, defining and targeting SAN is extremely challenging because, even during sinus rhythm, surface-only multielectrode mapping may not define the leading pacemaker sites in intramural SAN but instead misinterpret them as epicardial or endocardial exit sites through sinoatrial conduction pathways. These SAN exit sites may be distributed up to 50 mm along the CT beyond the ∼20-mm-long anatomic SAN structure. Moreover, because SAN reentrant tachycardia beats may exit through the same sinoatrial conduction pathway as during sinus rhythm, many SAN arrhythmias are underdiagnosed. Misinterpretation of arrhythmia sources and/or mechanisms (eg, enhanced automaticity, intranodal vs CT reentry) limits diagnosis and success of catheter ablation treatments for poorly understood SAN arrhythmias. The aim of this review is to provide a state-of-the-art overview of the 3D structure and function of the human SAN complex, mechanisms of SAN arrhythmias and available approaches for electrophysiological mapping, 3D structural imaging, pharmacologic interventions, and ablation to improve diagnosis and mechanistic treatment of SAN and atrial arrhythmias.
(Copyright © 2022 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.)
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معلومات مُعتمدة: R01 HL115580 United States HL NHLBI NIH HHS; R01 HL135109 United States HL NHLBI NIH HHS
فهرسة مساهمة: Keywords: Ablation; Adenosine; Crista terminalis; Optical mapping; Reentry; Sinoatrial node; Sinus tachycardia; Three-dimensional electroanatomic mapping
تواريخ الأحداث: Date Created: 20220916 Date Completed: 20230109 Latest Revision: 20240102
رمز التحديث: 20240102
مُعرف محوري في PubMed: PMC9897959
DOI: 10.1016/j.hrthm.2022.08.039
PMID: 36113768
قاعدة البيانات: MEDLINE
الوصف
تدمد:1556-3871
DOI:10.1016/j.hrthm.2022.08.039