Key result
AV conduction time is driven primarily by AV nodal delay rather than His-Purkinje conduction.
Why the study?
The relationship between atrioventricular conduction time and its individual contributors (the atrioventricular node and His-Purkinje system), as well as sex differences in these intervals, required investigation.
Does total atrioventricular conduction time depend more on conduction through the atrioventricular node or the His-Purkinje system in adults undergoing electrophysiological evaluation?
Observational (n=64)
Yes
Does total atrioventricular conduction time depend more on conduction through the atrioventricular node or the His-Purkinje system in adults undergoing electrophysiological evaluation?
This study demonstrates that total atrioventricular conduction time is primarily determined by conduction through the atrioventricular node rather than the His-Purkinje system, and highlights significant differences in absolute conduction times between sexes.
Observational data indicate AV conduction depends mainly on nodal intervals; hypothesis-generating for sex-specific EP reference ranges.
The electrical depolarization of the heart passes through various structures of the cardiac conduction system, which modify its conduction to different extents. In this study, we investigated the relationship between the atrioventricular conduction time (AV interval) and its contributors, the atrioventricular node (AVN) and the His–Purkinje system (HPS), as represented by the AH and HV intervals, respectively. We also compared sex differences in these intervals and their relations. Resting intracardiac tracings lasting 5 min were obtained from 64 patients (33 women) during an invasive electrophysiological study. The aforementioned intervals were measured for all consecutive beats. The mean AH interval was 85.9 ms, HV 43.7 ms, and AV 129.6 ms. Men had longer AH (80.0 vs. 65.9 ms), HV (38.4 vs. 35.3 ms), and AV intervals (124.7 vs. 108.5 ms) than women. The AV intervals were linearly correlated with AH intervals in all patients (r2 = 0.65). No significant correlation was found between AV and HV intervals in all patients (r2 = 0.05). There were no sex differences in these associations. Our results suggest that the atrioventricular conduction time depends mainly on the conduction through the AVN and less on the HPS. These relations are similar in both sexes, although men had longer conduction times through the AVN, HPS, and total atrioventricular conduction time.
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Żuchowski et al. (2023) conducted an observational in Patients undergoing invasive electrophysiological study (n=64). Atrioventricular node and His-Purkinje system conduction was evaluated on Correlation of atrioventricular conduction time (AV interval) with AH and HV intervals (r2 = 0.65 (AH) vs r2 = 0.05 (HV), p=<0.001). Atrioventricular conduction time (AV interval) depends significantly more on conduction through the atrioventricular node (AH interval, r2 = 0.65) than on the His-Purkinje system (HV interval, r2 = 0.05), with similar relative relationships in both sexes despite men having longer absolute conduction times.
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