Communication
Beyond the Intrinsic Cardiac Conduction System: A Hypothetical Framework for Cardiocutaneous Electrical Pathways (CEP) Linking Heart to Skin in ECG Generation
Oluwadare Ogunlade*
Issue:
Volume 13, Issue 4, August 2025
Pages:
60-65
Received:
14 June 2025
Accepted:
30 June 2025
Published:
23 July 2025
DOI:
10.11648/j.sd.20251304.11
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Abstract: The existing paradigm of cardiac electrophysiology primarily focuses on the intracardiac conduction system and volume conduction through interstitial fluid to explain the electrocardiogram (ECG). However, this model faces limitations in fully elucidating the precise capture of phasic electrical signals at the cutaneous surface. This short communication introduces a novel anatomical and physiological framework postulating the existence of Cardiocutaneous Electrical Pathways (CEP) - a specialized, direct extracardiac electrical system connecting the heart to the skin. This framework proposes that CEP extends along the body's vascular channels, which establish the essential physiological link between the heart and the skin through cutaneous circulation. These pathways are hypothesized to extend beyond the immediate circulation to the skin surface, thus generating a comprehensive cardiac electrical field across the entire integument. Consequently, the electrocardiogram is presented as a direct bioelectrical manifestation resulting from the activity at the terminal ends of these CEP. Correlational evidence, such as the observed disappearance of ECG signals from a body region following localized blood supply severance, supports the intrinsic association of these pathways with vascular networks. The CEP framework suggests that this microscopic extracardiac electrical system functions as a direct extension of the intracardiac electrical system. This novel hypothesis challenges conventional understandings of cardiac bioelectricity, opening new avenues for research into the anatomical basis of cardiac electrical propagation and its systemic manifestations. Further exploration of CEP could revolutionize electrodiagnostic methods and offer new targets for understanding cardiovascular physiology and disease.
Abstract: The existing paradigm of cardiac electrophysiology primarily focuses on the intracardiac conduction system and volume conduction through interstitial fluid to explain the electrocardiogram (ECG). However, this model faces limitations in fully elucidating the precise capture of phasic electrical signals at the cutaneous surface. This short communica...
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