Key result
Increased stimulation rate caused conduction blocks to the pectinate muscle at a longer cycle length than to the crista terminalis in 10 of 19 cases, influenced by unit bundle arrangement.
The arrangement and orientation of unit bundles in the right atrium are critical determinants of preferential conduction and block.
May inform canine atrial conduction models; leaves open translation to human arrhythmia mechanisms.
We studied conduction properties and histological findings at branching sites of the pectinate muscle (PM) from the crista terminalis (CT) in the dog right atrium. Propagation was faster in the longitudinal direction along CT than along PM. When the rate of stimulation was increased, conduction blocks to PM occurred at a longer cycle length than those to CT in 10 of 19 cases without differences in the refractory period. There were two block sites, one at the lateral edge within CT and the other at the branching site of PM from CT. The former was dominant with normal solution and the latter with high K+ solution. Histological studies showed no apparent differences between the two groups. CT consisted of a number of unit bundles in a longitudinal direction. The unit bundles continuing from the edge of CT proceeded into PM. Their orientation in PM, however, became irregular and tangled. Between the branches of PM, conduction block occurred unpredictably without regard to direction. These observations indicated the importance of the arrangement and orientation of the unit bundles in the appearance of the preferential conduction and block.
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Yamashita et al. (1987) studied this question. Increased rate of stimulation and high K+ solution vs. Normal solution / baseline stimulation was evaluated on Conduction blocks to the pectinate muscle. Increased stimulation rate caused conduction blocks to the pectinate muscle at a longer cycle length than to the crista terminalis in 10 of 19 cases, influenced by unit bundle arrangement.
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