Development of the conduction system of the heart

The muscle cells forming the myocardium and the muscle cells forming the intestinal smooth muscle layers, are both derived from the visceral mesoderm. All cardiomyocytes display autorhythmicity, intercellular conduction via gap junctions, and contraction, irrespective whether they are derived from atrium, ventricle, node, or bundles. It is the anatomical arrangement of the distinct components that is responsible for the coordinate contraction wave over the heart. These very basic principles have been insufficiently appreciated in most studies on the development of the conduction sytem, by which it got unnoticed that the proper anatomical arrangement is, in essence, layed down very early in development in the cardiac tube. In this review we will summarize recent immunohistochemical studies that have permitted this appreciation.*