Published online before print January 30, 2003, doi: 10.1161/01.RES.0000059304.97120.2F
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 2003 American Heart Association, Inc.
Integrative Physiology |
Cx43 and Dual-Pathway Electrophysiology of the Atrioventricular Node and Atrioventricular Nodal Reentry
From the Department of Biomedical Engineering (V.P.N., I.R.E.), Case Western Reserve University, Cleveland, Ohio; and the School of Biomedical Sciences (S.A.J., M.K.L., M.R.B.), University of Leeds, Leeds, UK.
Correspondence to Igor R. Efimov, PhD, Cardiac Bioelectricity Research and Training Center, Dept of Biomedical Engineering, Case Western Reserve University, 10900 Euclid Ave, Cleveland, OH 44106-7207. E-mail ire{at}po.cwru.edu
Fluorescent imaging has revealed that posterior nodal extensions provide the anatomical substrate for the dual-pathway electrophysiology of the atrioventricular (AV) node during normal conduction and reentry. The reentry can be intranodal, or as well as the posterior nodal extensions, it can involve an endocardial layer of atrial/atrial-nodal (A/AN) cells as part of the AV nodal reentry (AVNR) circuit. Using fluorescent imaging with a voltage-sensitive dye and immunolabeling of Cx43, we mapped the electrical activity and structural substrate in 3 types of AVNR induced by premature atrial stimulation in 8 rabbit hearts. In 6 cases, the AVNR pathway involved (1) a fast pathway (FP), (2) the A/AN layer, and (3) a slow pathway (SP). In 4 cases, reentry took the path (1) SP, (2) A/AN layer, and (3) FP. In 2 cases, reentry was intranodal, propagating between the 2 posterior nodal extensions. Immunolabeling revealed that the FP and SP are formed by Cx43-expressing bundles surrounded by tissue without Cx43. Cx43-expressing posterior nodal extensions are the substrate of AVNR during both intranodal and extranodal reentry.
Key Words: ablation • electrophysiology • arrhythmia • imaging
This article has been cited by other articles:
 |
|
 |
|
  U. Lisewski, Y. Shi, U. Wrackmeyer, R. Fischer, C. Chen, A. Schirdewan, R. Juttner, F. Rathjen, W. Poller, M. H. Radke, et al. The tight junction protein CAR regulates cardiac conduction and cell-cell communication J. Exp. Med., September 29, 2008; 205(10): 2369 - 2379. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Li, I. D. Greener, S. Inada, V. P. Nikolski, M. Yamamoto, J. C. Hancox, H. Zhang, R. Billeter, I. R. Efimov, H. Dobrzynski, et al. Computer Three-Dimensional Reconstruction of the Atrioventricular Node Circ. Res., April 25, 2008; 102(8): 975 - 985. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. J. Hucker, V. Sharma, V. P. Nikolski, and I. R. Efimov Atrioventricular conduction with and without AV nodal delay: two pathways to the bundle of His in the rabbit heart Am J Physiol Heart Circ Physiol, August 1, 2007; 293(2): H1122 - H1130. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Yoo, H. Dobrzynski, V. V. Fedorov, S.-Z. Xu, T. T. Yamanushi, S. A. Jones, M. Yamamoto, V. P. Nikolski, I. R. Efimov, and M. R. Boyett Localization of Na+ Channel Isoforms at the Atrioventricular Junction and Atrioventricular Node in the Rat Circulation, September 26, 2006; 114(13): 1360 - 1371. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Valderrabano, F. Chen, A. S. Dave, S. T. Lamp, T. S. Klitzner, and J. N. Weiss Atrioventricular Ring Reentry in Embryonic Mouse Hearts Circulation, August 8, 2006; 114(6): 543 - 549. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. V. Fedorov, W. J. Hucker, H. Dobrzynski, L. V. Rosenshtraukh, and I. R. Efimov Postganglionic nerve stimulation induces temporal inhibition of excitability in rabbit sinoatrial node Am J Physiol Heart Circ Physiol, August 1, 2006; 291(2): H612 - H623. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. R. Efimov, V. P. Nikolski, and G. Salama Optical Imaging of the Heart Circ. Res., July 9, 2004; 95(1): 21 - 33. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K.-G. Shyu, B.-W. Wang, Y.-H. Yang, S.-C. Tsai, S. Lin, and C.-C. Lee Amphetamine activates connexin43 gene expression in cultured neonatal rat cardiomyocytes through JNK and AP-1 pathway Cardiovasc Res, July 1, 2004; 63(1): 98 - 108. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. T. Sambelashvili, V. P. Nikolski, and I. R. Efimov Virtual electrode theory explains pacing threshold increase caused by cardiac tissue damage Am J Physiol Heart Circ Physiol, June 1, 2004; 286(6): H2183 - H2194. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. K. Racker The AV junction region of the heart: a comprehensive study correlating gross anatomy and direct three-dimensional analysis. Part II. Morphology and cytoarchitecture Am J Physiol Heart Circ Physiol, May 1, 2004; 286(5): H1853 - H1871. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y.-S. Ko, H.-I Yeh, Y.-L. Ko, Y.-C. Hsu, C.-F. Chen, S. Wu, Y.-S. Lee, and N. J. Severs Three-Dimensional Reconstruction of the Rabbit Atrioventricular Conduction Axis by Combining Histological, Desmin, and Connexin Mapping Data Circulation, March 9, 2004; 109(9): 1172 - 1179. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. L. Wit Atrioventricular Nodal Electrophysiology: Still Exciting After All These Years Circ. Res., November 28, 2003; 93(11): 1018 - 1019. [Full Text] [PDF]
|
|
|
|
|
|
H. Dobrzynski, V. P. Nikolski, A. T. Sambelashvili, I. D. Greener, M. Yamamoto, M. R. Boyett, and I. R. Efimov Site of Origin and Molecular Substrate of Atrioventricular Junctional Rhythm in the Rabbit Heart Circ. Res., November 28, 2003; 93(11): 1102 - 1110. [Abstract] [Full Text] [PDF]
|
|