Demonstration of a Left Atrial Input to the Atrioventricular Node in Humans

Abstract
Background— During right atrial stimulation, the anterior and posterior approaches provide inputs to the atrioventricular (AV) node. The purpose of the present study was to determine how activation proceeding from the left atrium reaches the AV node. Methods and Results— We studied AV nodal conduction during right and left atrial (coronary sinus) stimulation in 46 patients (27 women and 19 men; mean age, 46±4 years) who had structurally normal hearts. At an identical cycle length (600 ms), left atrial stimulation resulted in shorter A-H intervals than right atrial stimulation (73±3 ms versus 99±3 ms; P Conclusion— The mitral annulus provides a left atrial input to the human AV node.

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