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Rudolph's PediatricsRudolph's Pediatrics

Section 26. Disorders of the Cardiovascular System > 

Part 2. Approach to the Patient with Cardiovascular Disease > 

Chapter 485. Arrhythmias

George F. Van Hare
Topics Discussed: atrioventricular accessory pathway; atrioventricular node; cardiac arrhythmia; cardiac conduction system; cardiac electrophysiology; cardiology; conduction, cardiac; electrocardiogram; electrophysiology (science); heart rate; heart rate variability; his-purkinje system; sinoatrial node; whole-cell recording.
Sections: Basic Features of Arrhythmias, Diagnosis, Treatment, Sinus Rhythm and Its Variants, Ectopic Supraventricular Rhythms, Ectopic Ventricular Arrhythmias, Abnormalities of Conduction, References.
Excerpt:"The heart has specialized cells collected into nodes and tracts. The sinoatrial node, near the junction of the superior vena cava and right atrium, has a rich vagal and sympathetic nerve supply and controls heart rate. Conduction of impulses from the sinoatrial node to the atrioventricular node occurs without a specialized conducting system. However, there are preferential pathways that have been termed internodal tracts. In addition, preferential conduction from the sinus node to the roof of the left atrium occurs over the Bachmann bundle, which is also not part of a specialized conduction system. The Bachmann bundle is important, however, in timing of left atrial contraction in relation to mitral valve opening. The slow cell-to-cell conduction through atrial myocardium explains the relatively long duration of the P wave...."
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