The atrioventricular (AV) node is a recurrent source of potentially life-threatening arrhythmias. Nevertheless, limited data are available on its developmental control or molecular phenotype. We used a novel AV nodal myocardium-specific reporter mouse to gain insight into the gene programs determining the formation and phenotype of the developing AV node. In this reporter, green fluorescent protein (GFP) expression was driven by a 160-kbp bacterial artificial chromosome with Tbx3 and flanking sequences. GFP was selectively active in the AV canal of embryos and AV node of adults, whereas the Tbx3-positive AV bundle and sinus node were devoid of GFP, demonstrating that distinct regulatory sequences and pathways control expression in the components of the conduction system. Fluorescent AV nodal and complementary Nppa-positive chamber myocardial cell populations of embryonic day 10.5 embryos and of embryonic day 17.5 fetuses were purified using fluorescence-activated cell sorting, and their expression profiles were assessed by genome-wide microarray analysis, providing valuable information concerning their molecular identities. We constructed a comprehensive list of sodium, calcium, and potassium channel genes specific for developing nodal or chamber myocardium. Furthermore, the data revealed that the AV node and the chamber (working) myocardium phenotypes diverge during development but that the functional gene classes characterizing both subtypes are maintained. One of the repertoires identified in the AV node-specific gene profiles consists of multiple neurotrophic factors and semaphorins, not yet appreciated to play a role in nodal development, revealing shared characteristics between nodal and nervous system development.
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http://dx.doi.org/10.1161/CIRCRESAHA.108.192443 | DOI Listing |
Eur Heart J Case Rep
January 2025
Department of Cardiology, Edgardo Rebagliati Martins National Hospital, Avenida Edgardo Rebagliati 490, Jesús María, Lima 15072, Perú.
Background: This case report highlights the conduction disorder anomalies associated with dengue infection, particularly bradyarrhythmias due to dysfunction of the sinus node and atrioventricular node, which may require cardiac stimulation such as pacemaker implantation. This case emphasizes the importance of continuous monitoring and the use of additional diagnostic techniques to detect complications in a timely manner.
Case Summary: A 31-year-old male patient was admitted to our institution with symptoms of dyspnoea, orthopnoea, and severe bradycardia.
Indian J Nucl Med
November 2024
Department of Cardiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Adenosine is extensively utilized in myocardial stress perfusion imaging for the detection and risk stratification of coronary artery disease. It has a well-established safety profile. The majority of the undesirable effects experienced during adenosine infusion are transient (owing to its brief half-life of ~10 s) and arise from the stimulation of receptors in the atrio-ventricular (AV) node (AV block) and bronchial smooth muscles (bronchospasm).
View Article and Find Full Text PDFExpert Rev Med Devices
January 2025
Cardiology Unit, "Card. G. Panico" Hospital, Tricase (Le), Italy.
Introduction: In patients with symptomatic, refractory atrial fibrillation the ablate and pace (A&P) strategy (pacemaker implantation followed by atrio-ventricular junction ablation (AVJA)) is superior to medical therapy in improving quality of life and prognosis. Despite its well-proven benefits, this invasive therapeutic option is still underutilized in clinical practice. The choice of pacing modality (right ventricular pacing, biventricular pacing, BVP, or conduction system pacing, CSP) is crucial and can have significant clinical implications.
View Article and Find Full Text PDFCureus
December 2024
Cardiology, Wright State University Boonshoft School of Medicine, Dayton, USA.
Permanent pacemaker (PPM) implantation is the standard of care in patients with complete heart block (CHB) and second-degree type II atrioventricular (AV) block irrespective of patient symptoms when the conduction abnormality is irreversible. CHB generally constitutes a medical emergency that can be fatal if not urgently treated. This is in contrast to first-degree AV block and second-degree type I AV block, which require PPM implantation only in very special circumstances.
View Article and Find Full Text PDFPacing Clin Electrophysiol
January 2025
Division of Cardiology, Department of Medicine, Weill Cornell Medicine, New York Presbyterian Hospital, New York, USA.
Leadless pacing technology now includesdedicated atrial helix-fixation leadless pacemakers (LPs), expanding theapplication of leadless devices for patients with sinus node dysfunction andatrioventricular block during sinus rhythm. This first reportedcase-series of atrial LPs describes and discusses the potential use-casescenarios of recently approved helix-fixation atrial LPs. The article highlights important concepts regarding their use, including implantationtechniques, programming, battery conservation, and the low rate of progressionof AV block in patients implanted with AAI(R) pacemakers.
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