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3 years ago
HCN4 (hyperpolarisation-activated, cyclic nucleotide gated 4) channels, the pore-forming α–subunits of ‘funny’ channels originally described in pacemaker cells of the sinoatrial node (SAN),1 are responsible for the early phase of diastolic depolarisation in these cells and are key determinants of pacemaker generation and control of heart rate.2–5 HCN4 channels are selectively expressed in the SAN…
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3 years ago
The sinoatrial or sinus node (SAN) is the heart’s natural pacemaker. Located in the superior right atrium, it automatically produces cyclical electrical activity to initiate each heartbeat in normal sinus rhythm. SAN dysfunction (SND) in humans, also known as ‘sick sinus syndrome’, can manifest as pathological bradycardia and asystolic pauses. As a result, SND can lead to symptoms of reduced…
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3 years ago
Atrial fibrillation (AF) is a highly prevalent arrhythmia that represents an important burden on healthcare systems. The presence of AF is associated with an increased risk of conditions such stroke, heart failure and dementia. Further, AF is associated with increased mortality. Over the past half century, significant advances have been made in understanding the pathobiology of AF. Important…
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3 years ago
Since the identification of the hyperpolarisation-activated cyclic nucleotide channel 4 (HNC4), a major constituent of the pacemaker current (If) in the sinoatrial node, as a modulator of heart rate,1 several genetic causes of sinus bradycardia by means of mutations in ion channel encoding genes have been described. They may result in isolated sick sinus sydrome or other arrhythmia and…
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3 years ago
More than 100years have passed since the atrioventricular node (AVN) was first discovered by Sunao Tawara1 and described as a “Knoten” of tissue located at the proximal end of the Bundle of His (BoH).2 Despite the numerous advances in knowledge regarding the structure and function of the AVN, there are still several controversies that need to be addressed in both clinical and scientific settings…
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3 years ago
The link between sudden unexplained death in individuals with mental health problems who are administered antipsychotic drugs has been recognised for over a century.1 A clear relationship has emerged over the past 25 years between antipsychotic drugs, prolongation of the QT interval of the ECG, atypical polymorphic tachycardia known as torsade de pointes (TdP) and sudden cardiac death (SCD). A…
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3 years ago
Atrial fibrillation (AF) is the most commonly encountered arrhythmia in clinical practice. The discovery that pulmonary veins (PV) play a prominent role in the pathogenesis of AF has revolutionised the management of AF. PV isolation has become the most widely used technique for treatment of paroxysmal AF. Since the initial discovery implicating PVs in AF pathogenesis, the mechanistic link between…
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3 years ago
General understanding of early repolarisation (ER) has dramatically changed in the last decade. For several years, ER has been considered a benign electrocardiographic (ECG) finding with high prevalence in the general population. Recently different studies have challenged this view and showed a significant association with life-threatening arrhythmias.1–5
In 2008 Haïssaguerre et al. first…
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1 year ago
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3 years ago
The introduction of cardiac electroanatomic mapping systems in the mid-1990s has permitted investigators to record intracardiac electrograms (EGMs) with accurate spatial localisation in 3D.1 These 3D mapping systems have enabled the display of the cardiac chambers as an anatomical shell upon which voltage, or activation, information can be displayed. Most commonly, colour is used to represent the…
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