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The CCS produces and transmits electrophysiological impulses for regulating the coordinated heart contractions, and CCS disorders cause cardiac arrhythmia. The current clinical imaging modalities cannot visualize the CCS morphology in living patients. However, one of the few in situ structures invisible in 3D is the human cardiac conduction system (CCS), due to its minute size and deep localization, and lack of a specific tracer for in situ CCS imaging. Current advanced imaging modalities with applied tracing and processing techniques allow high-quality visualization of almost all internal structures and regions of interest in the human body 1, 2, 3, 4, 5, 6. Advances in future imaging modalities and methodology are essential for further accurate in situ 3D CCS visualization.Ĭorrect anatomical mapping is fundamental and crucial for biomedical sciences. In situ localization of the human CCS provides accurate anatomical localization with morphometric data, and it indicates the useful correlation between heart inclination and CCS rotation axes for predicting the variable and invisible human CCS in the living body.
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Both actual dissection and its CT image-based simulation identified that when the cardiac inclination changed from standing to lying, the sinus node shifted from the dorso-superior to the right outer position and the atrioventricular conduction axis changed from a vertical to a leftward horizontal position. The 3D CCS transformation by cardiac inclination changes from the standing to the lying position is also provided.
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This study is the first to document the successful 3D visualization of the CCS from the sinus node to the bundle branches within the human body, based on our specialized physical micro-dissection and its CT imaging. Current advanced imaging modalities with applied tracing and processing techniques provide excellent visualization of almost all human internal structures in situ however, the actual 3D internal arrangement of the human cardiac conduction system (CCS) is still unknown.