© 2000 by European Society of Cardiology
Copyright © 2000, European Society of Cardiology
The sinoatrial node, a heterogeneous pacemaker structure
aSchool of Biomedical Sciences, University of Leeds, Leeds LS2 9JT, UK
bResearch Institute of Environmental Medicine, Nagoya University, Nagoya 464-8601, Japan
* Corresponding author. Tel.: +44-113-233-4298; fax: +44-113-233-4224 m.r.boyett{at}leeds.ac.uk
This article focuses on the regional heterogeneity of the mammalian sinoatrial (SA) node in terms of cell morphology, pacemaker activity, action potential configuration and conduction, densities of ionic currents (iNa, iCa,L, ito, iK,r, iK,s and if), expression of gap junction proteins (Cx40, Cx43 and Cx45), autonomic regulation, and ageing. Experimental studies on the single SA node cell to the whole animal are reviewed. The heterogeneity is considered in terms of the gradient model of the SA node, in which there is gradual change in the intrinsic properties of SA node cells from periphery to centre, and the alternative mosaic model, in which there is a variable mix of atrial and SA node cells from periphery to centre. The heterogeneity is important for the dependable functioning of the SA node as the pacemaker for the heart, because (i) via multiple mechanisms, it allows the SA node to drive the surrounding atrial muscle without being suppressed electrotonically; (ii) via an action potential duration gradient and a conduction block zone, it promotes antegrade propagation of excitation from the SA node to the right atrium and prevents reentry of excitation; and (iii) via pacemaker shift, it allows pacemaking to continue under diverse pathophysiological circumstances.
KEYWORDS Gap junctions; Ion channels; Sinus node
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H. Honjo, M. R Boyett, S. R Coppen, Y. Takagishi, T. Opthof, N. J Severs, and I. Kodama Heterogeneous expression of connexins in rabbit sinoatrial node cells: correlation between connexin isotype and cell size Cardiovasc Res, January 1, 2002; 53(1): 89 - 96. [Abstract] [Full Text] [PDF]
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Members of the Sicilian Gambit New Approaches to Antiarrhythmic Therapy, Part I: Emerging Therapeutic Applications of the Cell Biology of Cardiac Arrhythmias Circulation, December 4, 2001; 104(23): 2865 - 2873. [Abstract] [Full Text] [PDF]
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Members of the Sicilian Gambit New approaches to antiarrhythmic therapy; emerging therapeutic applications of the cell biology of cardiac arrhythmias Eur. Heart J., December 1, 2001; 22(23): 2148 - 2163. [Abstract] [PDF]
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Members of the Sicilian Gambit New approaches to antiarrhythmic therapy: emerging therapeutic applications of the cell biology of cardiac arrhythmias Cardiovasc Res, December 1, 2001; 52(3): 345 - 360. [Abstract] [Full Text] [PDF]
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H. Dobrzynski, D. D.R. Marples, H. Musa, T. T. Yamanushi, Z. Henderson, Y. Takagishi, H. Honjo, I. Kodama, and M. R. Boyett Distribution of the Muscarinic K+ Channel Proteins Kir3.1 and Kir3.4 in the Ventricle, Atrium, and Sinoatrial Node of Heart J. Histochem. Cytochem., October 1, 2001; 49(10): 1221 - 1234. [Abstract] [Full Text] [PDF]
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T. Opthof Function and structure of the mouse sinus node: nothing you can see that isn't shown Cardiovasc Res, October 1, 2001; 52(1): 1 - 4. [Full Text] [PDF]
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E.E. Verheijck, M. J.A. van Kempen, M. Veereschild, J. Lurvink, H. J. Jongsma, and L. N. Bouman Electrophysiological features of the mouse sinoatrial node in relation to connexin distribution Cardiovasc Res, October 1, 2001; 52(1): 40 - 50. [Abstract] [Full Text] [PDF]
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M. E. Mangoni and J. Nargeot Properties of the hyperpolarization-activated current (If) in isolated mouse sino-atrial cells Cardiovasc Res, October 1, 2001; 52(1): 51 - 64. [Abstract] [Full Text] [PDF]
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M Lei, H Honjo, I Kodama, and M R Boyett Heterogeneous expression of the delayed-rectifier K+ currents iK,r and iK,s in rabbit sinoatrial node cells J. Physiol., September 15, 2001; 535(3): 703 - 714. [Abstract] [Full Text] [PDF]
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D. J. Huelsing, A. E. Pollard, and K. W. Spitzer Transient outward current modulates discontinuous conduction in rabbit ventricular cell pairs Cardiovasc Res, March 1, 2001; 49(4): 779 - 789. [Abstract] [Full Text] [PDF]
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E. E. Verheijck, R. Wilders, and L. N. Bouman Atrio-Sinus Interaction Demonstrated by Blockade of the Rapid Delayed Rectifier Current Circulation, February 19, 2002; 105(7): 880 - 885. [Abstract] [Full Text] [PDF]
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