ArticleCirculation research2009
Structural and functional evidence for discrete exit pathways that connect the canine sinoatrial node and atria.
Article in Circulation research, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers.
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Who cites it
75 citing papers in PubMed, 126 citations in OpenAlex.
- An integrated platform for 2-D and 3-D optical and electrical mapping of arrhythmias in Langendorff-perfused rabbit hearts.The Journal of physiology · 2026Article
- Heart rate variability in dogs with brachycephalic obstructive airway syndrome evaluated during wakefulness and sleep.Journal of veterinary internal medicine · 2026Article
- Inferior Sino-Atrial Node Exit Sites Are Associated With Electrical Remodeling.JACC. Clinical electrophysiology · 2026Article
- Aging and sinus node dysfunction: mechanisms and future directions.Clinical science (London, England : 1979) · 2025Review
- Calcium-directed feedback control of the sinoatrial node robustness.Biophysical journal · 2023Article
- Optical mapping of contracting hearts.The Journal of physiology · 2023Review
- Three-dimensional functional anatomy of the human sinoatrial node for epicardial and endocardial mapping and ablation.Heart rhythm · 2023Review
- Pseudo superior vena cava entrance block during sinus rhythm uncovered by continuous atrial pacing.Journal of arrhythmia · 2022Article
- Improved Generation of Human Induced Pluripotent Stem Cell-Derived Cardiac Pacemaker Cells Using Novel Differentiation Protocols.International journal of molecular sciences · 2022Article
- An Exploratory Study on Vectorcardiographic Identification of the Site of Origin of Focally Induced Premature Depolarizations in Horses, Part I: The Atria.Animals : an open access journal from MDPI · 2022Article
- Mechanisms of Sinoatrial Node Dysfunction in Heart Failure With Preserved Ejection Fraction.Circulation · 2022Article
- Circle Method for Robust Estimation of Local Conduction Velocity High-Density Maps From Optical Mapping Data: Characterization of Radiofrequency Ablation Sites.Frontiers in physiology · 2022Article
- Molecular Profiling of the Cardiac Conduction System: the Dawn of a New Era.Current cardiology reports · 2021Review
- Assembly of the Cardiac Pacemaking Complex: Electrogenic Principles of Sinoatrial Node Morphogenesis.Journal of cardiovascular development and disease · 2021Review
- Electrophysiological and Molecular Mechanisms of Sinoatrial Node Mechanosensitivity.Frontiers in cardiovascular medicine · 2021Article
- The Effects of Valvular Heart Disease on Atrial Conduction During Sinus Rhythm.Journal of cardiovascular translational research · 2020Article
- From Genome-Wide Association Studies to Cardiac Electrophysiology: Through the Maze of Biological Complexity.Frontiers in physiology · 2020Review
- Optocardiography and Electrophysiology Studies of Ex Vivo Langendorff-perfused Hearts.Journal of visualized experiments : JoVE · 2019Article
- Engineered Cardiac Pacemaker Nodes Created by TBX18 Gene Transfer Overcome Source-Sink Mismatch.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2019Article
- Late Outcomes of Surgical Ablation for Inappropriate Sinus Tachycardia.The Annals of thoracic surgery · 2019Article
15 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
Surface electrode recordings cannot delineate the activation within the human or canine sinoatrial node (SAN) because they are intramural structures. Thus, the site of origin of excitation and conduction pathway(s) within the SAN of these mammals remains unknown. Canine right atrial preparations (n=7) were optically mapped. The SAN 3D structure and protein expression were mapped using immunohistochemistry. SAN optical action potentials had diastolic depolarization and multiple upstroke components that corresponded to the separate excitations of the node and surface atrial layers. Pacing-induced SAN exit block eliminated atrial optical action potential components but retained SAN optical action potential components. Excitation originated in the SAN (cycle length, 557+/-72 ms) and slowly spread (1.2 to 14 cm/sec) within the SAN, failing to directly excite the crista terminalis and intraatrial septum. After a 49+/-22 ms conduction delay within the SAN, excitation reached the atrial myocardium via superior and/or inferior sinoatrial exit pathways 8.8+/-3.2 mm from the leading pacemaker site. The ellipsoidal 13.7+/-2.8/4.9+/-0.6 mm SAN structure was functionally insulated from the atrium. This insulation coincided with connexin43-negative regions at the borders of the node, connective tissue, and coronary arteries. During normal sinus rhythm, the canine SAN is functionally insulated from the surrounding atrial myocardium except for 2 (or more) narrow superior and inferior sinoatrial exit pathways separated by 12.8+/-4.1 mm. Conduction failure in these sinoatrial exit pathways leads to SAN exit block and is a modulator of heart rate.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.