Current concepts of anatomy and electrophysiology of the sinus node

The sinoatrial node, or sinus node, of humans is the principal pacemaker of the heart. Over the last century, studies have unraveled the complex molecular architecture of the sinus node and the expression of unique ion channels within its specialized myocytes. Aim of this review is to describe the embriology, the anatomy, the histology and the electrophisiology of the sinus node.

[1]  M. Taylor,et al.  Reconstruction of the human sinoatrial node , 1967, The Anatomical record.

[2]  D. Allen,et al.  Store-Operated Ca2+ Influx and Expression of TRPC Genes in Mouse Sinoatrial Node , 2007, Circulation research.

[3]  J. Boineau,et al.  Origin of the Sinus Impulse , 1996, Journal of cardiovascular electrophysiology.

[4]  D DiFrancesco,et al.  Reciprocal role of the inward currents ib, Na and if in controlling and stabilizing pacemaker frequency of rabbit sino-atrial node cells , 1992, Proceedings of the Royal Society of London. Series B: Biological Sciences.

[5]  Robert H. Anderson,et al.  New insights into pacemaker activity: promoting understanding of sick sinus syndrome. , 2007, Circulation.

[6]  Julian F. Thayer,et al.  Accentuated antagonism in the control of human heart rate , 2000, Clinical Autonomic Research.

[7]  D DiFrancesco,et al.  A new interpretation of the pace‐maker current in calf Purkinje fibres. , 1981, The Journal of physiology.

[8]  H. Zhang,et al.  Connexins in the sinoatrial and atrioventricular nodes. , 2006, Advances in cardiology.

[9]  M. Eldar,et al.  Point Mutation in the HCN4 Cardiac Ion Channel Pore Affecting Synthesis, Trafficking, and Functional Expression Is Associated With Familial Asymptomatic Sinus Bradycardia , 2007, Circulation.

[10]  E. Lakatta,et al.  Dynamic interactions of an intracellular Ca2+ clock and membrane ion channel clock underlie robust initiation and regulation of cardiac pacemaker function. , 2008, Cardiovascular research.

[11]  K. R. Anderson,et al.  Location and vascular supply of sinus node in human heart. , 1979, British heart journal.

[12]  S. Ho,et al.  The Architecture of the Sinus Node, the Atrioventricular Conduction Axis, and the Internodal Atrial Myocardium , 1998, Journal of cardiovascular electrophysiology.

[13]  A. Moorman,et al.  Tbx3 controls the sinoatrial node gene program and imposes pacemaker function on the atria. , 2007, Genes & development.

[14]  D. DiFrancesco,et al.  Heart rate reduction via selective 'funny' channel blockers. , 2007, Current opinion in pharmacology.

[15]  S. Siegelbaum,et al.  Molecular mechanism of cAMP modulation of HCN pacemaker channels , 2001, Nature.

[16]  D. Sánchez-Quintana,et al.  Sinus node revisited in the era of electroanatomical mapping and catheter ablation , 2005, Heart.

[17]  Robert H. Anderson,et al.  Molecular Architecture of the Human Sinus Node: Insights Into the Function of the Cardiac Pacemaker , 2009, Circulation.

[18]  M. Sheppard,et al.  Localisation and quantitation of autonomic innervation in the porcine heart I: conduction system , 1999, Journal of anatomy.

[19]  萩原 誠久,et al.  Contribution of two types of calcium currents to the pacemaker potentials of rabbit sino-atrial node cells , 1989 .

[20]  T. C. West,et al.  Ultramicroelectrode recording from the cardiac pacemaker. , 1955, The Journal of pharmacology and experimental therapeutics.

[21]  S. Ho,et al.  The surgical significance of the atrial branches of the coronary arteries. , 1984, International journal of cardiology.

[22]  E. Lakatta,et al.  Normal heart rhythm is initiated and regulated by an intracellular calcium clock within pacemaker cells. , 2007, Heart, lung & circulation.

[23]  L. Bouman,et al.  Age-related changes in structure and relative collagen content of the human and feline sinoatrial node. A comparative study. , 1995, European heart journal.

[24]  J. Borer,et al.  The funny current: cellular basis for the control of heart rate. , 2007, Drugs.

[25]  A E Becker,et al.  Functional and Morphological Organization of the Rabbit Sinus Node , 1980, Circulation research.

[26]  Ruben Coronel,et al.  Pacemaker current (I(f)) in the human sinoatrial node. , 2007, European heart journal.

[27]  H Honjo,et al.  Regional differences in the role of the Ca2+ and Na+ currents in pacemaker activity in the sinoatrial node. , 1997, The American journal of physiology.

[28]  L N Bouman,et al.  Electrophysiology of the ageing rabbit and cat sinoatrial node--a comparative study. , 1993, European heart journal.

[29]  M. Yacoub,et al.  Innervation of the human cardiac conduction system. A quantitative immunohistochemical and histochemical study. , 1994, Circulation.

[30]  R. Hudson THE HUMAN PACEMAKER AND ITS PATHOLOGY* , 1960, British heart journal.

[31]  A Keith,et al.  The Form and Nature of the Muscular Connections between the Primary Divisions of the Vertebrate Heart. , 1907, Journal of anatomy and physiology.

[32]  Vadim V Fedorov,et al.  Structural and Functional Evidence for Discrete Exit Pathways That Connect the Canine Sinoatrial Node and Atria , 2009, Circulation research.

[33]  F Lombardi,et al.  Sudden cardiac death: role of heart rate variability to identify patients at risk. , 2001, Cardiovascular research.

[34]  W. Giles,et al.  Ionic currents that generate the spontaneous diastolic depolarization in individual cardiac pacemaker cells. , 1985, Proceedings of the National Academy of Sciences of the United States of America.

[35]  H. Kulbertus,et al.  Histopathological correlates of sinoatrial disease. , 1978, British heart journal.

[36]  T. N. James,et al.  Comparative Ultrastructure of the Sinus Node in Man and Dog , 1966, Circulation.

[37]  M. Boyett,et al.  Modulation of pacemaker activity of sinoatrial node cells by electrical load imposed by an atrial cell model. , 1995, The American journal of physiology.

[38]  A. Moorman,et al.  The transcriptional repressor Tbx3 delineates the developing central conduction system of the heart. , 2004, Cardiovascular research.

[39]  E. Lakatta,et al.  Modern concepts concerning the origin of the heartbeat. , 2013, Physiology.

[40]  H. Brown,et al.  Cardiac pacemaking in the sinoatrial node. , 1993, Physiological reviews.

[41]  Robert H. Anderson,et al.  New insights into Sick Sinus Syndrome , 2007 .

[42]  K. Banach,et al.  The relevance of non‐excitable cells for cardiac pacemaker function , 2007, The Journal of physiology.

[43]  M. Malik,et al.  Circadian Behavior of P‐Wave Duration, P‐Wave Area, and PR Interval in Healthy Subjects , 2001, Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc.

[44]  E. Bozler TONUS CHANGES IN CARDIAC MUSCLE AND THEIR SIGNIFICANCE FOR THE INITIATION OF IMPULSES , 1943 .

[45]  J. Jalife,et al.  Cardiac Electrophysiology: From Cell to Bedside , 1990 .

[46]  E. Lakatta,et al.  Sinoatrial Nodal Cell Ryanodine Receptor and Na + -Ca 2+ Exchanger: Molecular Partners in Pacemaker Regulation , 2001, Circulation research.

[47]  J. Olgin,et al.  Radiofrequency catheter modification of the sinus node for "inappropriate" sinus tachycardia. , 1995, Circulation.