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Part V – Arrhythmias, Sudden Death, and Syncope

Chapter 35 – Genesis of Cardiac Arrhythmias  :  Electrophysiologic Considerations

Michael Rubart,
Douglas P. Zipes

  ANATOMY OF THE CARDIAC CONDUCTION SYSTEM, 653
  Sinoatrial Node, 653
  Atrioventricular Junctional Area and Intraventricular Conduction System, 656
  Innervation of the Atrioventricular Node, His Bundle, and Ventricular Myocardium, 658
  Arrhythmias and the Autonomic Nervous System, 659

  BASIC ELECTROPHYSIOLOGIC PRINCIPLES, 660
  Physiology of Ion Channels, 660
  Intercalated Discs, 663
  Phases of the Cardiac Action Potential, 664
  Normal Automaticity, 669

  MECHANISMS OF ARRHYTHMOGENESIS, 672
  Disorders of Impulse Formation, 672
  Disorders of Impulse Conduction, 676
  Tachycardias Caused by Reentry, 678

  REFERENCES, 684
Anatomy of the Cardiac Conduction System

Sinoatrial Node

In humans, the sinoatrial node is a spindle-shaped structure composed of a fibrous tissue matrix with closely packed cells. It is 10 to 20 mm long, 2 to 3 mm wide, and thick, tending to narrow caudally toward …