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Cardiac pacemaker cells display a spontaneous electrical rhythm - rate is dependent on location within the heart and speed of the membrane potential drift to threshold. Contractile cells have a stable membrane potential and require an electrical stimulus from the autorhythmic cells to initiate action potential and ultimately cardiac contraction.
Cardiac pacemaker cells display a spontaneous electrical rhythm - rate is dependent on location within the heart and speed of the membrane potential drift to threshold. Contractile cells have a stable membrane potential and require an electrical stimulus from the autorhythmic cells to initiate action potential and ultimately cardiac contraction.
Cardiac pacemaker cells display a spontaneous electrical rhythm - rate is dependent on location within the heart and speed of the membrane potential drift to threshold. Contractile cells have a stable membrane potential and require an electrical stimulus from the autorhythmic cells to initiate action potential and ultimately cardiac contraction.
February 14, 2013 The Heart Aorta Superior vena cava Pulmonary veins Right atrium Right ventricle Inferior vena cava Pulmonary artery Pulmonary veins Left atrium Left ventricle Interventricular septum Sherwood Fig. 9-4a, p. 303 The Heart Wall Endocardium (inner) Layer of endothelial cells Myocardium (middle) Cardiac muscle Epicardium (outer) Pericardium Double-walled membranous sac Cardiac Muscle (myocardium) Aerobic muscle 99% contractile cells 1% autorhythmicity cells Self-excitate Intercalated discs Anatomy of conduction system Sinoatrial (SA) node Internodal pathway Right branch of bundle of His Right ventricle Purkinje fibers Left branch of bundle of His Atrioventricular (AV) node Interatrial pathway Sherwood Fig. 9-8, p. 306 Atrioventricular (AV) bundle Pacemaker cells All cardiac pacemaker cells display a spontaneous electrical rhythm Rate is dependent on location within the heart and speed of the membrane potential drift to threshold Sinoatrial (SA) node Cardiac pacemaker Intrinsic rate of 80-100 A.P./min Conduction speed of 0.05m/sec
Atrioventricular (AV) node Intrinsic rate of 40-60 A.P./min Conduction speed of 0.05m/sec Bundle of His Intrinsic rate of 20-40 A.P./min Conduction speed of 1m/sec
Purkinje fibres Intrinsic rate of 15-40 A.P./min Conduction speed of 4m/sec Electrical Activity in Pacemaker Cell Autorhythmic cells are leaky to Na+ and therefore have a unstable membrane potential Pacemaker potential- membrane potential drifts towards threshold Initiates action potential and ultimately cardiac contraction Electrical Activity in Contractile Cells Contractile cells have a stable membrane potential and require an electrical stimulus from the autorhythmic cells to contract Excitation-Contraction Coupling Electrical Activity in Contractile Cells Refractory period means tetanus of cardiac muscle is impossible. Cardiac contractile cells APs exhibit a prolonged plateau phase accompanied by a prolonged period of contraction. Summary: An effective heart All achieved by the electrical properties of the cardiac muscle Regular contractions at appropriate rate for metabolism (ANS control) Guaranteed time for ventricular filling after atrial and ventricular contractions (refractory period) Contraction duration long enough for physical movement of fluid (plateau phase) Contractile strength sufficient to generate appropriate pressures (plateau phase) Ventricular pressure directed towards exit valves (intrinsic conduction system) Coordination of left & right, and atrial & ventricular contractions (intrinsic conduction system) Matched volume of emptying and filling (intrinsic conduction system) Electrocardiogram Recording of the surface electrical activity of the heart from electrodes placed on skin Body fluids are conductors Non-invasive Comparison of voltages detected by electrodes at two points Reflects the cardiac cycle SUM of activity in ALL cardiac muscle Exact pattern of activity depends on orientation of electrodes The ECG Waves reflect depolarization and repolarization events Baseline reflects when there is no overall depolarization or repolarization Occurs when muscle is at rest, and during sustained contraction Spread of depolarization General direction of spread of depolarization Cardiac Vector (normally between -10 o and +100 o ) 0 o 180 o ECG Timing P wave 80-100ms
PR interval 120-200ms
QRS Complex 80-120ms
ST segment 70-80ms
T wave ~200ms RR interval reflects entire duration of each heart beat Clinical ECG 1 horizontal box= .2s (small box 0.04s), 5 boxes = 1sec 10 small division upward or downward= 1millivolt http://library.med.utah.edu/kw/ecg/image_index/index.html Assessment of orientation of the heart Localisation of areas that do not conduct electrical activity normally Assessment of myocardial hypertrophy or atrophy Accurate measurement of heart rate (60/RR interval) Respiratory Sinus Arrhythmia Marquette Electronics Copyright 1996 http://library.med.utah.edu/kw/ecg/image_index/index.html Normal
HR with inspiration
HR with expiration
Expressed more in young and fit Bradycardia & Tachycardia Bradycardia !60bts/min Chronic exercise training Vagal stimulation Tachycardia " 100 bts/min Increased body temperatures Sympathetic stimulation Exercise Breakdown of SA node pacemaker authority Impulse from SA node is blocked before it enters atria Latent pacemakers pick up authority No/small p-waves clue: Atrial fibrillation Heart block 1 st degree: delay in conduction, prolonged P-R interval >0.2s, QRS same 2 nd degree: incomplete heart block, P-R interval between .25-.45sec, atria beating faster than ventricles- dropped beats Compete AV block: P-wave regular frequency completely unrelated to ventricular firing, Ventricular QRS followed by T wave normal. Breakdown of ventricular coupling or refractory period Breakdown of left/right ventricular coupling- Same mechanisms that cause AV block QRS may be considerable abnormal Breakdown of refractory safety period Hypertrophy can cause different refractory periods in epicardium & endocardium (Ectopic beats) Left Ventricular Hypertrophy High blood pressure
In exercise- adaptation to increased preload/ afterload
Often seen in athletes http://library.med.utah.edu/kw/ecg/image_index/index.html Summary: ECG
An ECG tracing records the electrical activity of the heart Waves reflect depolarization and repolarization events Intervals reflect timing Both have diagnostic value