By Jay L. Jordan, Iwao Yamaguchi, William J. Mandel (auth.), Felix I. M. Bonke (eds.)
For the clinician the sinus node is kind of a hidden constitution and in basic terms via oblique overview he's in a position to say whatever in regards to the functionality of this heart of pacemaker task. The morphologist, although, is ready to describe the structural microscopic or even electronmicroscopic positive factors of this constitution. the single drawback is that, once he's entering the image, the tissue is lifeless. The physiologist attempts to enquire the electrophysiological habit of the sinus node. considering the fact that there's not a man or woman prepared to provide his sinus node for learn, he has to do his research on remoted arrangements of animals. even though there are various specialists within the box of the sinus node they approximately by no means converse an identical 'language'. accordingly, it was once my dream to carry all these humans - or no less than a few of them -together on a workshop. I had the sensation that it was once vital to prepare any such assembly with no an viewers yet purely with 'experts'.
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Extra resources for The Sinus Node: Structure, Function, and Clinical Relevance
An other explanation is the occurrence of a second degree retrograde sinoatrial block (Goldreyer and Damato, 1971), leading to a slower discharge of the sinus node (Bigger and Strauss, 1973). 5 sec. It is interesting to observe that in contrast to animal studies, in man a driving rate of less than 10-15% above the control rate does not induce a sinus node acceleration. Only a slowing down of the sinus node is seen. ad 2. , 1971). Narula et aI. (1972) came to the same conclusion when pacing for 2 respectively 5 min.
Performing the high rate test Masini and Dianda (1977) found normal values in most oftheir patients who were classified as "functional sinus bradycardia' '. " There was no correlation between the SACT and the symptoms of the patients. The same was true for the SNRT (Figure 7). The problem is that in most of the patients we do not know the mechanisms of syncope. During our long-term tape recordings we found that in some patients the symptoms are not related to rhythm disturbances. The same was reported by others (DeSilva and Shubrooks 1977).
This method is based upon the known electrophysiological phenomenon of postdrive or overdrive suppression. The purpose of this paper is to review our knowledge of this phenomenon in the human heart, in healthy subjects as well as in patients with diseases of the sinus node. Before proceeding with the data obtained in man, we briefly. will review the knowledge on this phenomenon in the experimental animal. SINUS NODE POSTDRIVE SUPPRESSION IN THE EXPERIMENTAL ANIMAL As early as 1884, Gaskel found that pacemaker activity of the tortoise heart tissue is inhibited by tetanic stimuli.