Branching pattern of sinoatrial and atrioventricular nodal arteries in patients undergoing cardiac catheterization in a tertiary care hospital

Divyaprakash M, Suma M. P., Jagadish H. R., Girish P. G.


Background: The (SA) sinoatrial node and (AV) atrioventricular nodal blood supply is highly variable and recording of the anatomic variants of the arterial blood supply to the SA node and AN node will help to overcome potential complications following ablation procedures or in valvular surgeries. The objectives were to study the blood supply of the conducting system and its relation with the coronary artery dominance and to find the origins of the major atrial arteries in patients undergoing coronary angiography.

Methods: The study included 300 consecutive patients (104 females, 196 males) admitted for diagnostic coronary angiography at PMSSY, superspeciality hospital, BMC and RI, Bangalore, India. The coronary angiography was done in a conventional manner without any specific views for atrial arteries. The origins of sinoatrial and atrioventricular nodal arteries and its relation with the arterial dominance were recorded.

Results: The RCA is dominant in 77.20%, LCX is dominant in 18.43% of patients and codominant in 4.37% of the patients. The SA nodal artery arises from the RCA in 57.20% of the patients, by the circumflex branch of the LCA in 40.14% and by both coronary arteries in 2.66% of patients. The AV nodal artery was also commonly arises from the RCA (78.22%) than by the Cx branch of the LCA (18.66%).

Conclusions: The data from our study may help the cardiac surgeons, cardiologists and electrophysiologists in their day today practice.


Atrioventricular nodal artery, Circumflex artery, LCA, RCA, Sinoatrial nodal artery

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