Key result
Cardiac fulcrum anchors the helical myocardium and integrates directly with conduction and autonomic structures.
Histological analysis of 84 mammalian hearts suggests the cardiac fulcrum serves a dual anatomical and functional role by mechanically supporting the helical myocardial band while integrating with the atrioventricular node and autonomic nervous system.
Suggests novel fulcrum-AV node coupling in mammals; leaves open relevance to human arrhythmias or device therapies.
Objective: We have studied the relationship of the Cardiac Fulcrum in its anatomical location, without unfolding the heart into its muscular band arrangement. The objective is to observe the relationships of the Fulcrum with the other anatomical elements. Material and Methods: The methods used in this research to explain the hypothesis of the anatomy functional integrity of the heart of: 1. The use of consisted 84 hearts sourced from morgues, slaughterhouses (bovine, humans and porcine). 2. Histological and histochemical analysis of the anatomical samples. Results: We observed that in both bovine and porcine models, as well as in humans, the Fulcrum presents a configuration featuring a central area and two poles. A pointed right pole inserts into the velamentous sector of the tricuspid valve, and a left pole-ovoid in bovines or forming a double arch in porcine- inserts into the ascending loop of the left ventricle and is in intimate contact with the atrio ventricular node. The central zone of the Fulcrum constitutes the lever arm. This configuration allows the Fulcrum to transmit a pulsatile rocking motion to the atrio ventricular node. The Fulcrum and the atrio ventricular node regulate and modulate the afferent information from the organism before converting it into the efferent depolarization wave. Therefore, the Fulcrum is the physical component that allows the electrical system or depolarization waves to couple or decouple (modulate), providing the myocardium with an efferent message in response to the afferent messages received from all somatic nodes that report on the internal and external environment of the organism. Conclusions: The final conclusion is that the fulcrum has a dual function. First, it supports the double helix that shapes the anatomy of the heart; and second, it acts as a transmitter by integrating with the atrioventricular node and the autonomic nervous system.
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Jorge Carlos Trainini (2026) studied Normal cardiac anatomy (cardiac fulcrum and atrioventricular node) (n=84). Histological, histochemical, and neurofilament immunostaining analysis of the cardiac fulcrum and atrioventricular node was evaluated on Anatomical and histological relationship between the cardiac fulcrum, atrioventricular node, Purkinje cells, and autonomic nervous system. Histological analysis of 84 hearts demonstrated that the cardiac fulcrum (~3 cm arm with two poles) physically anchors the helical myocardium and integrates with the AV node and autonomic nerves.
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