PR Interval and Junctional Zone

Giuseppe Bagliani; Domenico Giovanni Della Rocca; Luigi Di Biase; Luigi Padeletti

doi:10.1016/j.ccep.2017.05.003

PR Interval and Junctional Zone

Card Electrophysiol Clin. 2017 Sep;9(3):411-433. doi: 10.1016/j.ccep.2017.05.003.

Authors

Giuseppe Bagliani¹, Domenico Giovanni Della Rocca², Luigi Di Biase³, Luigi Padeletti⁴

Affiliations

¹ Arrhythmology Unit, Cardiology Department, Foligno General Hospital, Via Massimo Arcamone, 06034 Foligno (PG), Italy; Cardiovascular Diseases Department, University of Perugia, Piazza Menghini 1, 06129 Perugia Italy. Electronic address: giuseppe.bagliani@tim.it.
² Department of Cardiovascular Medicine, University of Rome Tor Vergata, Rome, Italy; Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 N IH 35, Ste 700, Austin, TX 78705, USA.
³ Texas Cardiac Arrhythmia Institute, St. David's Medical Center, 3000 N IH 35, Ste 700, Austin, TX 78705, USA; Department of Biomedical Engineering, University of Texas, Austin, TX, USA; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
⁴ Heart and Vessels Department, University of Florence, Largo Brambilla, 3, 50134 Florence, Italy; IRCCS Multimedica, Cardiology Department, Via Milanese, 300, 20099 Sesto San Giovanni, Italy.

PMID: 28838548
DOI: 10.1016/j.ccep.2017.05.003

Abstract

The atrioventricular junction is a pivotal component of the cardiac conduction system, a key electrical relay site between the atria and the ventricles. The sophisticated functions carried out by the atrioventricular junction are possible for the presence of a complex apparatus made of specialized anatomic structures, cells with specific ion-channel expression, a well-organized spatial distribution of intercellular junctions (connexins), cells with intrinsic automatism, and a rich autonomic innervation. This article reviews the main anatomic and electrophysiologic features of the atrioventricular junction, with a focus on cardiac preexcitation.

Keywords: Accessory pathway; Atrioventricular junction; Cardiac pre-excitation; PR interval; Wenckebach periodicity.

Publication types

Review

MeSH terms

Atrial Fibrillation
Atrioventricular Node / physiopathology*
Electrocardiography
Heart Conduction System / physiopathology*
Humans