PR Interval and Junctional Zone - 23/08/17

Doi : 10.1016/j.ccep.2017.05.003

Giuseppe Bagliani, MD ^a,^b,^⁎ , Domenico Giovanni Della Rocca, MD ^c,^d, Luigi Di Biase, MD, PhD ^d,^e,^f,^g, Luigi Padeletti, MD ^h,ⁱ
^a Arrhythmology Unit, Cardiology Department, Foligno General Hospital, Via Massimo Arcamone, 06034 Foligno (PG), Italy
^b Cardiovascular Diseases Department, University of Perugia, Piazza Menghini 1, 06129 Perugia Italy
^c Department of Cardiovascular Medicine, University of Rome Tor Vergata, Rome, Italy
^d Texas Cardiac Arrhythmia Institute, St. David’s Medical Center, 3000 N IH 35, Ste 700, Austin, TX 78705, USA
^e Department of Biomedical Engineering, University of Texas, Austin, TX, USA
^f Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
^g Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
^h Heart and Vessels Department, University of Florence, Largo Brambilla, 3, 50134 Florence, Italy
ⁱ IRCCS Multimedica, Cardiology Department, Via Milanese, 300, 20099 Sesto San Giovanni, Italy

^∗Corresponding author. Arrhythmology Clinic Unit, Cardiology Department, Foligno General Hospital, Foligno, Italy.Arrhythmology Clinic UnitCardiology DepartmentFoligno General HospitalFolignoItaly

Résumé

The atrioventricular junction is a pivotal component of the cardiac conduction system, a key electrical relay site between the atria and the ventricles. The sophisticated functions carried out by the atrioventricular junction are possible for the presence of a complex apparatus made of specialized anatomic structures, cells with specific ion-channel expression, a well-organized spatial distribution of intercellular junctions (connexins), cells with intrinsic automatism, and a rich autonomic innervation. This article reviews the main anatomic and electrophysiologic features of the atrioventricular junction, with a focus on cardiac preexcitation.

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Keywords : PR interval, Atrioventricular junction, Wenckebach periodicity, Accessory pathway, Cardiac pre-excitation