open access

Vol 59, No 3 (2000)
ORIGINAL ARTICLES
Published online: 2000-07-06
Submitted: 2012-02-06
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Histologic evaluation of the atrioventricular nodal artery in healthy humans and in patients with conduction disturbances

Dariusz Kozłowski, Adam Owerczuk, Edward Koźluk, Marek Grzybiak, Monika Adamowicz-Kornacka, Ewa Walczak, Franciszek Walczak
Folia Morphol 2000;59(3):145-152.

open access

Vol 59, No 3 (2000)
ORIGINAL ARTICLES
Published online: 2000-07-06
Submitted: 2012-02-06

Abstract

The anatomy of the conduction system of the heart so relevant in the contemporary invasive cardiology is not fully understood. It has turned out that ablation procedures bring new information as to its structure and function, but in some cases can result in complete a-v block. Atrioventricular nodal artery located within the nodal-perinodal tissue can probably be damaged during the ablation procedures. Therefore, we decided to explore in detail the morphology and the topography of the atrioventricular nodal artery in healthy humans and in patients with clinical traits of a-v conduction disturbances requiring permanent pacing.
The microscopic study was carried out on 30 normal human hearts specimens (17F, 3M) from 17 to 86 years of age, and on 20 hearts with conduction disturbances (11F, 9M) from 39 to 85 years of age. We found that the number of the atrioventricular node arteries is different and independent of the extent that induces block causing conduction disturbances. The topography of the artery in perinodal zone was consistent in normal hearts, yet in hearts with conduction disturbances we observed about 2% of deviations in its location. It might be the reason for generation of iatrogenic complications after invasive cardiological procedures. The morphology revealed changes in 50% of the examined hearts and their vessel walls, which was declared to be connected with ageing. This correlated with certain stages of atherosclerosis as well as hypertension characteristic of elderly patients. We observed that in 33% of hearts from control group small parietal thrombi were detected and in 60% of paced group respectively. Hence, it seems that the procedures in perinodal zone should be performed in its proximal part because of a minor probability of direct and indirect (through nodal artery) damage of the atrioventricular structure of the junction.

Abstract

The anatomy of the conduction system of the heart so relevant in the contemporary invasive cardiology is not fully understood. It has turned out that ablation procedures bring new information as to its structure and function, but in some cases can result in complete a-v block. Atrioventricular nodal artery located within the nodal-perinodal tissue can probably be damaged during the ablation procedures. Therefore, we decided to explore in detail the morphology and the topography of the atrioventricular nodal artery in healthy humans and in patients with clinical traits of a-v conduction disturbances requiring permanent pacing.
The microscopic study was carried out on 30 normal human hearts specimens (17F, 3M) from 17 to 86 years of age, and on 20 hearts with conduction disturbances (11F, 9M) from 39 to 85 years of age. We found that the number of the atrioventricular node arteries is different and independent of the extent that induces block causing conduction disturbances. The topography of the artery in perinodal zone was consistent in normal hearts, yet in hearts with conduction disturbances we observed about 2% of deviations in its location. It might be the reason for generation of iatrogenic complications after invasive cardiological procedures. The morphology revealed changes in 50% of the examined hearts and their vessel walls, which was declared to be connected with ageing. This correlated with certain stages of atherosclerosis as well as hypertension characteristic of elderly patients. We observed that in 33% of hearts from control group small parietal thrombi were detected and in 60% of paced group respectively. Hence, it seems that the procedures in perinodal zone should be performed in its proximal part because of a minor probability of direct and indirect (through nodal artery) damage of the atrioventricular structure of the junction.
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Keywords

atrioventricular nodal artery; atrioventricular node; junctional area; microscopic evaluation; conduction disturbances; pacing; ablation

About this article
Title

Histologic evaluation of the atrioventricular nodal artery in healthy humans and in patients with conduction disturbances

Journal

Folia Morphologica

Issue

Vol 59, No 3 (2000)

Pages

145-152

Published online

2000-07-06

Bibliographic record

Folia Morphol 2000;59(3):145-152.

Keywords

atrioventricular nodal artery
atrioventricular node
junctional area
microscopic evaluation
conduction disturbances
pacing
ablation

Authors

Dariusz Kozłowski
Adam Owerczuk
Edward Koźluk
Marek Grzybiak
Monika Adamowicz-Kornacka
Ewa Walczak
Franciszek Walczak

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