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Bradycardia
AV NODE
- Subendocardial structure originating in the transitional zone
- (Composed of aggregates of cells in the posterior-inferior right
atrium)
- Compact AV node: ~1 x 3 x 5 mm
- Situated at the apex of triangle of Koch
- Triangle of Koch
Posterior: coronary sinus ostium
Anterior: septal tricuspid valve annulus
Superior: tendon of Todaro superiorly
BLOOD SUPPLY:
AV Bundle:
AV Nodal Artery
first perforator of the left anterior
descending cor. artery
Bundle Branches:
septal perforators of the left anterior
desc. Cor. Artery
branches of the posterior descending
cor. artery
Innervation:
AV Node
-highly innervated with postganglionic sympathetic and
parasympathetic nerves.
Exercise
Improve conduction through
Administration of drugs such as the AV node
atropine and isoproterenol impair infranodal conduction.
Congenital CHB and a narrow QRS complex
-exercise typically increases heart rate
Temporary or Permanent
Artificial Pacing
-most reliable treatment for patients
with symptomatic AV conduction system
disease.
PERMANENT PACEMAKER
-required for conduction block distal to the AV node