房室交界区的特化心肌纤维构筑

ARCHITECTURE OF THE SPECIALIZED MYOCARDIAL FIBERS OF THE ATRIOVENTRICULAR JUNCTION AREA

The architecture of the specialized myocardial fibers of the atrioventricular junction area(AVJ) were observed under microscope on serial sections. It was found that the human A-V node extend backward divergently to form two posterior extensions (left and right, LPE, RPE). The A-V node can be divided into a superficial layer and a deep layer, and the deep layer further divided into a upper part and a lower part. The fibers in the superficial layer are vertical, and join with the lower part of the deep layer at the anterior extremity of the node. The lower part of the deep layer is the main axis of the node. The fibers in the lower part of the deep layer are longitudinal, and join with the RPE at the posterior extremity of the node. The fibers in the upper part of the deep layer are oblique and join with the LPE at the posterior extremity of the node, and mix with the lower part at the anterior extremity. The longitudinal dissociation of the anterior part of the His bundle is more distinct than that of the posterior part. The lower-left part of the bifurcating part of the bundle extend to form the posterior left branch, the upper-left and upper-middle parts of the bifurcating part extend to form the anterior left branch, and the right part and lower-middle part of the bifurcating part extend to form the right bundle branch. The morphological evidence of the dual or multiple conducting pathways, the longitudinal dissociation and the reentry pathways in the AVJ were discussed.