The specialized rings and the endless saga of the AV node puzzle
2009; Elsevier BV; Volume: 6; Issue: 5 Linguagem: Inglês
10.1016/j.hrthm.2009.01.032
ISSN1556-3871
Autores Tópico(s)Cardiovascular Syncope and Autonomic Disorders
ResumoWhen, in 1906, Tawara 1 Tawara S. Das Reizleitungssystem des Saugetierherzens Eine anatomisch-histologische Studie uber das Atrioventrikularbundel und die Purkinjeschen Faden. Gustav Fischer, Jena1906 Google Scholar published the results and interpretations of his observations in the monumental “Das Reizleitungssystem des Saugetierherzens,” it looked like the time had finally come to celebrate the solution of a puzzle that had thwarted some of the most eminent physiologists/anatomists/pathologists of the time: Stanley Kent (who erroneously proposed multiple pathways crossing the atrioventricular junction 2 Kent A.F.S. Researches on the structure and function of the mammalian heart. J Physiol. 1893; 14: 233-254 Google Scholar ), Wilhelm His (who provided the first account of the atrioventricular [AV] conduction bundle 3 His Jr, W. Die Tatigkeit des embryonalen Herzens und deren Bedeutung fur die Lehre von der Herzbewegung beim Erwachsenen. Arbeiten aus der Medizinischen Klinik zu Leipzig. 1893; 1: 14-49 Google Scholar ), and Arthur Keith (the discoverer, with Flack, of the sinus node 4 Keith A. Flack M.W. The form and nature of the muscular connection between the primary divisions of the vertebrate heart. J Anatomic Physiol. 1907; 41: 172-189 PubMed Google Scholar ). Keith remained skeptical for many years about His's claims until Tawara's clarification of the AV anatomical arrangements provided him with the guidance to validate these findings. 5 Keith A. Flack M.W. The auriculo-ventricular bundle of the human heart. Lancet. 1906; 2: 359-364 Abstract Scopus (63) Google Scholar
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