The Conduction System of the Heart: Structure, Function and Clinical Implications

ISBN-13: 9789024720804 / Angielski / Miękka / 1978 / 708 str.

Hein J. J. Wellens; Hein J. J. Wellens; H. J. J. Wellens

Opis

This monograph had its genesis in a workshop on the specific conduction held in the spring of 1975. The meeting was organized to discuss present knowledge on structure and function of the cardiac specialized tissues with emphasis on their clinical implications. Since much new information was presented, the participants agreed to prepare manuscripts and make their material available for publication. This has resulted in a book in which the cardiac specialized tissues are discussed by different specialists: the electron-microscopist, anatomist, pathologist, physiologist, physicist and clinician. Apart from their interest in the cardiac conduction system the participants shared the opinion that their contribu- tion should be relevant to the understanding and treatment of patients with cardiac arrhythmias. The book should be useful for the clinician, the morphologist and the physio- logist. The workshop took place at the University Department of Cardiology, Wilhelmina Gasthuis, Amsterdam, The Netherlands. This is the home ground of one of the most outstanding electro cardiologists of our time, Dr. Dirk Durrer. By pairing genius and originality with endless fund of energy and dogged persistence he made several important contributions to modern cardiac electrophysiology. In recent years he created a cardio- logical institute where workers from various disciplines cooperate in the study and treat- ment of cardiac disease. Several of his pupils participated in the workshop and contributed to this volume. In appreciation and thankfulness we want to dedicate this book to Dr. Dirk Durrer.

Spis treści

Anatomy and electrophysiology of the developing conducting system.- 1. The development of the cardiac specialized tissue.- 2. Electrophysiology of the intact neonatal canine atrioventricular conducting system.- Electronmicroscopy of the conducting system.- 3. The fine structure of the atrial and atrio-ventricular (AV) junctional specialized tissues of the rabbit heart.- Impulse formation and conduction.- 4. Recent observations supporting the role of the slow current in cardiac electrophysiology.- 5. Effect of autonomic activity on pacemaker function and conduction.- 6. Supernormal excitability and conduction.- 7. The role of phase 3 and phase 4 block in clinical electrocardiography.- 8. The electrophysiologic basis of parasystole and its variants.- 9. Some effects of electrical stimulation on impulse initiation in cardiac fibers; its relevance for the determination of mechanisms of clinical cardiac arrhythmias.- 10. The effect of antiarrhythmic agents on impulse formation and impulse conduction.- Sinus node and atrium.- 11. The sinoatrial node and its connections with the atrial tissues.- 12. Direct and indirect techniques in the evaluation of sinus node function.- 13. Studies on the effect of drugs on sinus node-atrial conduction.- 14. Observations on circusmovement tachycardia in the isolated rabbit atrium.- The atrioventricular junction, the bundle branches and the ventricle.- 15. Morphology of the human atrioventricular junctional area.- 16. Pathological basis of concept of left hemiblock.- 17. Electrophysiology and structure of the atrioventricular node of the isolated rabbit heart.- 18. Influence of geometry on the shape of the propagated action potential.- 19. Electrophysiology of endocardial intraventricular conduction: The role and function of the specialized conducting system.- 20. The experimental evidence for the role of phase 3 and phase 4 block in the genesis of A-V conduction disturbances.- 21. Ventricular activation in human and canine bundle branch block.- 22. Depressed conduction and unidirectional block in Purkinje fibers.- 23. Newer aspects of concealed conduction of the cardiac impulse.- 24. The role of the conduction system in supraventricular tachycardia.- 25. Electrophysiological diagnosis and manifestation of dual A-V nodal pathways.- 26. Incidence of different types of A-V block and their localization by His bundle recordings.- 27. Patterns of V-A conduction in the human heart in the presence of normal and abnormal A-V conduction.- 28. Gap phenomena: Antegrade and retrograde.- 29. Accommodation of A-V nodal conduction and fatigue phenomenon in the His-Purkinje system.- 30. Epicardial mapping and surgical treatment in six cases of resistant ventricular tachycardia not related to coronary artery disease.- The Wolff-Parkinson-White syndrome.- 31. The electrophysiologic properties of the accessory pathway in the Wolff-Parkinson-White syndrome.- 32. Correlation between catheter electrophysiologic studies and findings on mapping of ventricular excitation in the W.P.W. syndrome.- 33. Ventricular excitation in the Wolff-Parkinson-White syndrome.- Myocardial infarction.- 34. Mechanisms of ectopic rhythm formation due to myocardial ischemia: Effects of heart rate and ventricular premature beats.- 35. Observations during electrical stimulation of the heart in patients with sinus bradycardia following acute myocardial infarction.- 36. A-V nodal block in acute myocardial infarction.- 37. Bundle branch block and acute myocardial infarction.- Bibliography on the conduction system.- Index of subjects.