Anatomic Basis for Preexcitation Syndromes

  • Donald B. Hackel


The usual and normal route to ventricular excitation is via the sino-auricular nodeatrioventricular (AV) node-His bundle-bundle branch system. The AV node is a region in which impulse conduction is normally delayed. Although the mechanism for the this delay is not agreed upon, it is an important feature of the AV node which helps to maintain an orderly sequence of atrial and ventricular contraction. However, there are several potential routes, by which the normal AV node-common bundle pathway may be bypassed, and which are, for the most part, made up of morphologically normal myocytes which often permit initiation of ventricular depolarization prior to that anticipated from activation via the normal conduction system. The main contribution of this chapter will be to describe these various potential bypass pathways which provide an anatomical basis for the occurrence of preexcitation. The terminology used will, for the most part, be that recommended by the European Study Group for Preexcitation [1].


Accessory Pathway Versus Node Bypass Tract Reentrant Tachycardia Versus Pathway 
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© Martinus Nijhoff Publishing 1986

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  • Donald B. Hackel

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