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The Sinus Node: Structure, Function and Clinical Relevance

The Sinus Node: Structure, Function and Clinical Relevance

          
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About the Book

For the clinician the sinus node is more or less a hidden structure and only by indirect assessment he is able to say something about the function of this center of pacemaker activity. The morphologist, however, is able to describe the structural microscopic and even electronmicroscopic features of this structure. The only disadvantage is that, as soon as he is coming into the picture, the tissue is dead. The physiologist tries to investigate the electrophysiological behavior of the sinus node. Since there is not a human being willing to give his sinus node for research, he has to do his investigation on isolated preparations of animals. Though there are a lot of experts in the field of the sinus node they nearly never speak the same 'language'. Therefore, it was my dream to bring all those people - or at least some of them -together on a workshop. I had the feeling that it was important to organize such a meeting without an audience but only with 'experts'.

Table of Contents:
Section one: Function and dysfunction of the sinus node.- Function and dysfunction of the sinus node: clinical studies in the evaluation of sinus node function.- Measurement of sinus node recovery time after atrial pacing.- Programmed atrial stimulation used for the calculation of sinoatrial conduction time (SACT) in man.- The pattern of the first and second return cycle after premature atrial stimulation.- Programmed atrial stimulation and rapid atrial pacing in patients with sinus pauses and sinoatrial exit block.- A new technique for measurement of sinoatrial conduction time.- Relevance of diagnostic atrial stimulation for pacemaker treatment in sinoatrial disease.- The response of the sinus node to premature stimulation of the atrium studied with microelectrodes in isolated atrial preparations of the rabbit heart.- Review of the significance of drugs in the sick sinus node syndrome.- Effect of propranolol on normal and abnormal sinus node function.- Dual effect of verapamil on sinus node function in man.- General conclusions: Limitations of sinus node function testing in patients with known or suspected sinus node disease.- Section two: Relation between structure and function of the sinus node.- The fine structure of the sinus node: a survey.- The development of the sinoatrial node.- Techniques and problems in correlating cellular electrophysiology and morphology in cardiac nodal tissues.- Ultrastructural and functional aspects of the rabbit sinoatrial node.- General comments.- Section three: Electrophysiology of the sinus node.- A general introduction about the current status of the electrophysiology of the sinus node.- Characterization of a two-component upstroke in the sinus node subsidiary pacemakers.- Pacemaker shifts in the sinus node: effects of vagal stimulation, temperature, and reduction of extracellular calcium.- Cardiac glycosides and pacemaker activity of the sinus node: a micro-electrode study on the isolated right atrium of the rabbit.- Effects of polarization and of inhibitors of ionic conductances on the action potentials of nodal and perinodal fibers in rabbit sinoatrial node.- The acceleratory action of the vagus on the sinus node.- General conclusions.- Section four: On the mechanism of pacemaking in the sinus node.- Ionic currents in rabbit sinoatrial node cells.- Fine structure of the small sinoatrial node specimen used for the voltage clamp experiment.- Membrane currents underlying rhythmic activity in frog sinus venosus.- Involvement of the chloride ions in the membrane currents underlying pacemaking activity in frog atrial trabeculae.- Which ions are important for the maintenance of the resting membrane potential of the cells of the sinoatrial node of the rabbit?.- Does spontaneous activity arise from phase 4 depolarization or from triggering?.- On the possible mechanism underlying spontaneous pacemaking.- General comments: ionic currents underlying spontaneous rhythm of the cardiac primary pacemaker cells.- Section five: Does the sinus node play a role in reentrant arrhythmias?.- Clinical evidence for sinus node reentry.- Sequence of atrial activation in patients with atrial echo beats.- Re-entry within the sinoatrial node as demonstrated by multiple micro-electrode recordings in the isolated rabbit heart.- Role of sinus node re-entry in the genesis of sustained cardiac arrhythmias.- General conclusions.- Literature Reference List.


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Product Details
  • ISBN-13: 9789024720644
  • Publisher: Springer
  • Publisher Imprint: Kluwer Academic Publishers
  • Language: English
  • Returnable: N
  • Sub Title: Structure, Function and Clinical Relevance
  • ISBN-10: 9024720648
  • Publisher Date: 31 Jul 1978
  • Binding: Hardback
  • No of Pages: 468
  • Series Title: English
  • Weight: 1090 gr


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