The cardiac conduction system initiates and propagates each heartbeat. Specialized conducting cells are a well-conserved phenomenon across vertebrate evolution, although mammalian and avian species harbor specific components unique to organisms with four-chamber hearts. Early histological studies in mammals provided evidence for a dominant pacemaker within the right atrium and clarified the existence of the specialized muscular axis responsible for atrioventricular conduction. Building on these seminal observations, contemporary genetic techniques in a multitude of model organisms has characterized the developmental ontogeny, gene regulatory networks, and functional importance of individual anatomical compartments within the cardiac conduction system. This review describes in detail the transcriptional and regulatory networks that act during cardiac conduction system development and homeostasis with a particular emphasis on networks implicated in human electrical variation by large genome-wide association studies. We conclude with a discussion of the clinical implications of these studies and describe some future directions.

中文翻译：

---

心脏传导系统的发展。

心脏传导系统启动并传播每次心跳。专门的传导细胞是脊椎动物进化过程中一种保存完好的现象，尽管哺乳动物和鸟类物种含有四腔心脏生物特有的特定成分。哺乳动物的早期组织学研究提供了右心房内主要起搏器的证据，并阐明了负责房室传导的专门肌肉轴的存在。在这些开创性观察的基础上，大量模型生物体中的当代遗传技术已经表征了发育个体发育、基因调控网络和心脏传导系统内各个解剖隔室的功能重要性。这篇综述详细描述了在心脏传导系统发育和体内平衡过程中起作用的转录和调节网络，特别强调通过大型全基因组关联研究与人类电变异有关的网络。最后，我们讨论了这些研究的临床意义，并描述了一些未来的方向。