Arrhythmias & electrophysiology
Unraveling the enigmatic morphology of the atrioventricular conduction axis using hierarchical phase-contrast tomography
Authors' conclusion
HiP-CT provides high-resolution 3D visualization of the AV conduction axis in adult hearts, revealing its morphology and variability. These findings offer new insights into structure-function correlations relevant to clinical electrophysiology and interventional procedures.
Study context
- Population
- Adult human hearts (mean donor age 81.6 years) imaged at the European Synchrotron Radiation Facility
- Participants
- 5 adult human hearts
- Outcome
- Nonbranching bundle length
Main finding
As reported in the abstract
Range
2.49 to 8.80 mm
Mean
6.31 mm
Further findings
Branching pattern
- In all hearts, the axis branched first into a broad left bundle, followed by a cord-like right bundle branch
Additional superior septal pathways
- Hearts with additional superior septal pathways
- 4
Cardiomyocyte alignment
- Transition from interwoven cardiomyocytes in the node to parallel alignment in the insulated nonbranching bundle
Anatomic landmark
- A line from the anteroseptal commissure of the tricuspid valve to the medial papillary muscle reliably located the nonbranching bundle
Original publication
Unraveling the enigmatic morphology of the atrioventricular conduction axis using hierarchical phase-contrast tomography. Heart Rhythm. Published 17 July 2026. doi:10.
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