心房中隔及び其の周邊に於ける刺激傳播状態, 特に洞-田原系に就ての實驗的研究(第2報) : 心房中隔及び其の周圍組織の切斷實驗に就て

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As reported in part I, it could not be determined that the excitation was spread by which of the proper muscle or the specific muscle at the interatrial septum. Then, in this report, the specific conduction muscles which were related by Osawa as the systema sino-Tawara were cut by a small messer and the PQ intervals were mesured before and after cut.The summary and conclusion of this study are as follows : 1) The cut of the area of the systema septoangularis posterior were performed in 15 cases. In 13 cases, the PQ interval was prolonged or shortend less than 0.010 of a second after cut, that is, the change of the PQ interval was only a little.2) The cut of the area of the systema septoangularis anterior was performed in 23 cases. Then in 17 cases, which cut this system, the PQ interval was prolonged 0.011 to 0.042 of a second (histological examination in 9 cases) and in the cases which it could not be cut, the PQ interval practically did not change.3) In 17 cases, the cut was performed under the sinus coronarius which included the right auricular bundle and the left auricular bundle and the atrio-ventricular node. Then, in 8 cases which the right auricular bundle was cut (histological examination in 5 cases), the PQ interval was prolonged 0.020 to 0.157 of a second. In one case which the both auricular bundle were cut, the PQ interval was prolonged 0.033 of a second. In 4 cases which the atrio-ventricular node was injured, 2 cases A-V block, other 2 cases prolongation of the PQ interval 0.136 to 0.198 of a second (histological examination). In one case which the right and left auricular bundle and atrio-ventricular node were not injured by histological examination, it was recognized the prolongation of the PQ interval was slightly 0.007 to 0.016 of a second.4) In 2 cases in which the cut of the Torus Loweri was performed, the prolongation or shortening of the PQ interval was only 0.002 of a second.5) By contrast, when the right atrial free wall was cut, the PQ interval was prolonged or shortend only 0.008 of a second.6) In 7 cases, the PQ interval was prolonged 0.080 to 0.058 of a second by Bachmann's bundle (histological examination in 4 cases), and in cases which the prolongation of PQ interval was evident, the systema septo-angularis anterior was ligated with it or previously other systems had been ligated.From the above data, it was thought that the 4 specific atrial muscles which were noticed by Osawa, plaied an important role as the stimulus conduction system between the sinus node and the atrio-ventricular node. And in these 4 systems, particularly the systema septo-angularis anterior was most important and the system along the arteriola sini was next in normal conduction. And it seemed that the systema septo-angularis posterior was not so important and the system through the left atrium might play a role at specific occations. And the Torus Loweri was not significant as the stimulus conduction system.
社団法人日本循環器学会の論文
1959-09-20

心房中隔及び其の周邊に於ける刺激傳播状態, 特に洞-田原系に就ての實驗的研究(第2報) : 心房中隔及び其の周圍組織の切斷實驗に就て

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