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TheScientificWorldJOURNAL
Volume 8, Pages 239-269
http://dx.doi.org/10.1100/tsw.2008.40
Review Article

Development of the Cardiac Conduction System and the Possible Relation to Predilection Sites of Arrhythmogenesis

1Department of Anatomy and Embryology of the Leiden University Medical Center, Leiden, The Netherlands
2Department of Cardiology of the Leiden University Medical Center, Leiden, The Netherlands
3Department of Paediatric Cardiology of the Leiden University Medical Center, Leiden, The Netherlands

Received 23 July 2007; Revised 10 December 2007; Accepted 29 July 2008

Academic Editor: Robert E. Poelmann

Copyright © 2008 M. R. M. Jongbloed et al.

Abstract

The cardiac conduction system (CCS) encompasses a complex system responsible for the coordinated contraction of the heart. In the developing heart, as well as in the adult heart, tissues of the (putative) CCS are characterized by different properties than the surrounding working myocardium, which can be observed on a histological level, as well as by the expression patterns of several immunohistological and molecular markers. In recent years, many markers have been studied that have helped to elucidate the processes involved in CCS development. It has become clear that multiple genes, cells and their interactions are involved in this complex process. In this article, an overview of the current knowledge of CCS development is supplied. Furthermore, several controversies regarding conduction system development are discussed, as well as the possible significance of embryologic development of the CCS for the development of arrhythmias later in life.