Preliminary study of external interatrial muscle fascicles

• Autorzy: Kozlowski D , Kaminski R. , Piwko G. , Gawrysiak M. , Owerczuk A. , Piszczatowska G. , Budrejko S. , Kozlowska M. , Duda B. , Grzybiak M.
• Języki publikacji: EN

Abstrakty

EN

The atria are highly complex multidimensional structures composed of a heterogeneous branching network of subendocardial muscular bundles. The relief of the inner part of the right atrium includes the crista terminalis as well as multiple pectinate muscles that bridge the thinner atrial free walls and appendages. However, a handful of studies have focused attention on the role of the naturally occurring complexities of the atrial subendocardial muscle structures in the mechanisms of cardiac arrhythmias. In accordance with the facts mentioned above, it was decided to examine the morphology and topography of the external interatrial junctions and related structures in order to define the possible anatomical basis of impulse propagation in focal atrial fibrillation. Research was conducted on material consisting of 15 human hearts of both sexes (female — 6, male — 9) from 18 to 82 years of age. In addition we were concerned, on the basis of the history and electrocardiograph tracings, that none of the patients had shown focal and non-focal type of atrial fibrillation. The classic macroscopic methods of anatomical evaluation were used. The walls of the atria were prepared via a stereoscopic microscope, the pericardium and fatty tissue were eliminated from the surface of the atria, visualising muscle fibres linking both of the atria, and the beginnings and the endpoints of fascicles in the right and left atrium were estimated. The structure, large muscle bundle, was present in all examined hearts. The muscle fascicle was descending from the anterior wall of the right atrium just below the orifice of the superior vena cava. The fascicle, running towards the left atrium, divided into two branches, one of which joined with the superior fascicle from the posterior wall and created one running above the interatrial septum and infiltrating into the wall of the left atrium on its superior surface between the superior pulmonary veins. The other branch of the anterior fascicle was running across the anterior wall of the atria and it penetrated into the left atrium muscle in the region of the inferior pole of the left auricle outlet. On the posterior wall of the atria three types of interatrial fascicles were distinguished: unifascicular, bifascicular and trifascicular. The bifascicular type was the most frequent configuration (9 cases — 60.0%), in 5 cases it was trifascicular (33.3%) and finally the unifascicular configuration was observed in just 1 heart (6.7%). On the basis of our study we can conclude that the external interatrial fascicles are the constant structure of the heart, although they may have a variable morphology. Those structures could be responsible for physiological conduction between the atria and may play an important role in patients with atrial fibrillation.

Słowa kluczowe

EN

interatrial muscle; muscle fascicle; atrial fibrillation; anatomy; atrium; man; heart; male; female; electrocardiography; patient; atrial muscle

• Wydawca: -
• Czasopismo: Folia Morphologica
• Rocznik: 2002
• Tom: 61
• Numer: 2
• Opis fizyczny: p.97-101,fig.,ref.

Twórcy

autor

Kozlowski D

• Medical University of Gdansk, Kieturakisa 1, 80-742 Gdansk, Poland

autor

Kaminski R.

autor

Piwko G.

autor

Gawrysiak M.

autor

Owerczuk A.

autor

Piszczatowska G.

autor

Budrejko S.

autor

Kozlowska M.

autor

Duda B.

autor

Grzybiak M.

Bibliografia

• 1. Bachmann G (1916) The interauricular time interval. Am J Physiol, 41: 309–320.
• 2. Bailey GWH, Braniff BA, Hancock EW (1968) Relation of left atrial pathology to atrial fibrillation in mitral valve disease. Ann Intern Med, 69: 13–20.
• 3. Camm AJ (1997) Preface. In: Murgatroyd FD, Camm AJ (eds.) Nonpharmacological treatment of atrial fibrillation, Armonk, NY, Futurra.
• 4. van Dam RT, Durrer D (1961) Excitability and electrical activity of human myocardial strips from the left atrial appendage in cases of rheumatic mitral stenosis. Circ Res, 9: 509–514.
• 5. Dean JW, Ho SY, Rowland E, Mann J, Anderson RH. (1994) Clinical anatomy of the atrioventricular junctions. J Am Coll Card, 24: 1725–1731.
• 6. Flegel KM (1995) From delirium cordis to atrial fibrillation: historical development of a disease concept. Ann Intern Med, 122: 876–883.
• 7. Gray H (1987) Anatomy, descriptive and surgical, Chancellor Press, London.
• 8. Haissaguerre M, Jais P, Shah DC, Clementy J (2000) Catheter ablation for atrial fibrillation: clinical electrophysiology of linear lesions. In: Zipes DP, Jalife J (eds.) Cardiac electrophysiology from cell to bedside, Philadelphia, WB Saunders Company 994–1008.
• 9. Haissaguerre M, Jais P, Shah DC, Hocini M (1996) Right and left atrial radiofrequency catheter therapy of paroxysmal atrial fibrillation. J Cardiovasc Electrophysiol, 12: 1132–1144.
• 10. Lewis T (1925) The mechanism and graphic registration of the heart beat. Shaw & Sons, London, 319–374.
• 11. Orsós H (1910) Ein intramulraler Sehnenstrang des rechten Vorhofes. Verh Dtsch Ges Pathol, 14: 98–102.
• 12. Pastelin G, Mendez R, Moe GK (1978) Participation of atrial specialized conduction pathways in atrial flutter. Circ Res, 42: 386–393.
• 13. de Ponti R, Casari A, Salerno JA, Storti C, Zardini M, Ferrari A, Longobardi M (1992) Ablazione transcatetere mediante radiofrequenza delle vie anomale atrioventricolari sinistre: ruolo dell’approcio transettale. G Ital Cardiol, 22: 1255–1264.
• 14. Spach MS, Miller WT, Dolber PC (1982) The functional role of structural complexities in the propagation of depolarisation in atrium in the dog. Circ Res, 50: 175–191.
• 15. Sueda T, Nagata H (1997) Efficacy of a simple left atrial procedure for chronic atrial fibrillation in mitral valve operation. Ann Thorac Surg, 63: 1070–1075.
• 16. Sueda T, Nagata H, Shikata H (1996) Simple left atrial procedure for chronic atrial fibrillation associated with mitral valve disease. Ann Thorac Surg, 62: 1796–1800.