Reconstruction of the human sinoatrial node.

The superior vena cava and adjacent right atrium containing the sinoatrial node in each of five human hearts was studied histologically in serial section. The tissue block of a 41 year old man was reconstructed in four colors to provide a three-dimensional model of the sinoatrial node, atrial relations, blood supply and nodal configuration. The resulting model demonstrated the curved course of the compact sinoatrial node and the mural relations of its tapered superior and inferior ends. Microscopic measurements of the boundaries of the five human nodes yielded an epicardial to endocardial mean thickness in the compact body of the node of 1.6 mm, that of the lower node was 0.6 mm. The mean length of the five nodes was 7.3 mm. Such microscopic delineation of the node is more accurate than gross measurements and indicates that the size of this vital mass of pacemaker tissue in man is smaller than the larger measurements usually given in the literature. Small strands of nodal muscle fibers follow longer or shorter courses before they become continuous with the larger more darkly stained atrial cardiac muscle fibers. We found no histologic evidence within the human node, or along its periphery, of continuity between the small nodal fibers and very large atrial fibers.