Cardiac Electrophysiology Flashcards
Wave of depolarization ____ contraction
Preceeds
Pacemaker
SA node
Where the impulse is initiated = rate of about 70 impulses/min
1 cardiac cycle: SA Node –>
AV node –> Delay –> AV bundle –> L/R bundle branches –> Purkinje fibers
Resting Cardiac Ventricular Cell
Na Ca and K
Na and Ca higher outside
K higher inside
So at rest, inside is negative and outside is positive
Action Potentials differ depending on
Location in heart
What sets the pace
SA node
No nerves needed, everything starts here
Automaticity
SA node is leaky to Na –> Threshold
AP is similar in AV node, but slower so SA node is what is setting the pace
What causes the upstroke
Ca
What is happening during repolarization
K is leaving the cell
Influence of ANS on Heart Rate - NE
B1 –> cAMP –> (+) Ltype Ca channel
Inc if –> inc slope of phase 4 –> reach threshold faster –> inc heart rate
Influence of ANS on Heart Rate - Ach
Muscarinic receptors –> dec cAMP –> (-) L type Ca channel
Dec if –> dec slop of phase 4 –> reach threshold slower –> dec heart rate
Ach hyperpolarizes the membrane and shifts the threshold upward
Effective Refractory Period
No new AP can form
Relative Refractory Period
Is possible for a new AP to form but is very difficult
What is purpose of refractory period
Helps control AP direction, prevents tetany, and allows chambers time to fill
Phase 0
Influx of Na
Upstroke
Phase 1
Kto = transient outward
Lets K squeak out
Phase 2
Calcium channels (influx) Maintain depolarization
Phase 3
Repolarize
K leaves the cell
How is electrical activity measured in the heart
3 major waves
3 major waves
P wave = atrial depolarization
QRS complex = ventricular depolarization
T wave = ventricular repolarization
- Tau wave = atrial repolarization masked by QRS complex
Clinical Uses of measuring heart activity
Arrhythmias
Ischemia and infarction
Heart orientation
Abnormal electrolytes and drugs
Inflections occur due to
Electrical activity (potential) traveling toward the positive electrode
Fibrous Skeleton
Plate of fibrous dense CT btw atria and ventricles
Electrical insulation
Site for muscle attachment
ECG provides signal info on
- Direction that signal is moving
- Speed at which signal is moving (r-r interval; basis for heart rate)
- Mass of tissue through which it is moving (thicker mass, higher peak will be)
P Wave
Atrial Depolarization +
QRS Complex
Ventricular Depolarization
- + -