In cardiology, the cardiac skeleton, also known as the fibrous skeleton of the heart, is a high-density homogeneous structure of connective tissue that forms and anchors the valves of the heart, and influences the forces exerted by and through them. The cardiac skeleton separates and partitions the atria (the smaller, upper two chambers) from the ventricles (the larger, lower two chambers). The heart's cardiac skeleton comprises four dense connective tissue rings that encircle the mitral and tricuspid atrioventricular (AV) canals and extend to the origins of the pulmonary trunk and aorta. This provides crucial support and structure to the heart while also serving to electrically isolate the atria from the ventricles.

The unique matrix of connective tissue within the cardiac skeleton isolates electrical influence within these defined chambers. In normal anatomy, there is only one conduit for electrical conduction from the upper chambers to the lower chambers, known as the atrioventricular node. The physiologic cardiac skeleton forms a firewall governing autonomic/electrical influence until bordering the bundle of His which further governs autonomic flow to the bundle branches of the ventricles. Understood as such, the cardiac skeleton efficiently centers and robustly funnels electrical energy from the atria to the ventricles.

The structure of the components of the heart has become an area of increasing interest. The cardiac skeleton binds several bands of dense connective tissue, as collagen, that encircle the bases of the pulmonary trunk, aorta, and all four heart valves. While not a traditionally or "true" or rigid skeleton, it does provide structure and support for the heart, as well as isolate the atria from the ventricles. This is why atrial fibrillation almost never degrades to ventricular fibrillation. In youth, this collagen structure is free of calcium adhesions and is quite flexible. With aging, calcium and other mineral accumulation occur within this skeleton. Distensibility of the ventricles is tied to variable accumulation of minerals which also contributes to the delay of the depolarization wave in geriatric patients that can take place from the AV node and the bundle of His.

The right and left fibrous rings of heart (annuli fibrosi cordis) surround the atrioventricular and arterial orifices. The right fibrous ring is known as the annulus fibrosus dexter cordis, and the left is known as the annulus fibrosus sinister cordis. The right fibrous trigone is continuous with the central fibrous body. This is the strongest part of the fibrous cardiac skeleton.

The upper chambers (atria) and lower (ventricles) are electrically divided by the properties of collagen proteins within the rings. The valve rings, central body, and skeleton of the heart consisting of collagen are impermeable to electrical propagation. The only channel allowed (barring accessory/rare preexcitation channels) through this collagen barrier is represented by a sinus that opens up to the atrioventricular node and exits to the bundle of His. The muscle origins/insertions of many of the cardiomyocytes are anchored to opposite sides of the valve rings.

The atrioventricular rings serve for the attachment of the muscular fibers of the atria and ventricles, and for the attachment of the bicuspid and tricuspid valves.

The left atrioventricular ring is closely connected, by its right margin, with the aortic arterial ring; between these and the right atrioventricular ring is a triangular mass of fibrous tissue, the fibrous trigone, which represents the os cordis seen in the heart of some of the larger animals, such as the ox.

Lastly, there is the tendinous band, already referred to, the posterior surface of the conus arteriosus.