The Av Node-Fulcrum Unit. A Quantum Approach to the Cardiac Cycle

Objective: In the present investigation, the anatomical and histological relationship of the Cardiac Fulcrum with the atrioventricular node in hearts of the human, bovine, porcine and anuran species was analyzed, as well as the possible functionality between both structures and the actions derived from said electromechanical unit. Material and methods:The methods used in this research to explain consisted of:1) The use of 96 hearts from a morgue, slaughterhouse and breeding grounds: a) 17 human hearts (three at 8, 16, and 23 weeks of gestation, respectively; four infants at 30 days, 36 days, 10 weeks, and 27 weeks; one 4-year-old child; one 10-year-old child; and eight adults with an average weight of 300 g); b) 59 two-year-old bovine hearts weighing between 1300 and 1900 g (average 1650 g); c) 10 porcine hearts (400 g); 10 de anuros (Rhinella arenarum) 2) Histological and histochemical analysis of the anatomical samples. 3) Immunostaining technique for neurofilaments.4) The endo-and epicardial electrical activation of the left ventricle was studied in 5 humans using three-dimensional electroanatomical mapping. Results:We observed that in all the species studied (human, bovine, and porcine), the fulcrum has a central area and two poles.It is in close contact with the atrioventricular node.The fulcrum and the atrioventricular node regulate and modulate the body's afferent information before converting it into the depolarization wave.Conclusion: During this investigation, in both human and other species' hearts, histological analysis revealed that the fulcrum (the beginning and end of the continuous myocardium) is adjacent to the AV node, defining a space rich in plexuses with interconnected neurofilaments between both structures.The structural relationship between myocardial stimulation and its mechanical product was analyzed, based on the assumption that this electromechanical unit is undergoing a continuous process of self-organization in which time plays a fundamental role as a fourth dimension added to the three spatial dimensions.The mechanical consequence of the initiation of stimulation in the anatomical and functional unit between the AV node and the cardiac fulcrum, and the continuity of myocardial activation up to the anisotropic zone at the contiguity between the descending and ascending segments, is what generates myocardial torsion through the sequential opposition of movements.Each heartbeat is then a result of a reading of fluctuations in an external and internal environment, which enters through the autonomic system to the AV node in sync with the Fulcrum that generates rhythmic feedback with coupling and decoupling similar to a self-organizing process.