Cardiac arrhythmicity
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List the cardiac pacemakers in order of fastest to slowest
Sinoatrial node Atrioventricular node Bundle of His Purkinje fibres
What is the pace of the SA node?
60-100 beats/min
What is the pace of the AV node?
40-60 beats/min
What is the pace of the bundle of His?
40-60 beats/min
What is the pace of the Purkinje fibres?
20-40 beats/min
What three tracts come off the SA node?
Anterior: Bachman’s bundle Middle: Weckenbach’s Posterior: Thorel’s
Describe an SA node action potential
4 0 3 4 Smooth
Describe a ventricular action potential
4 0 1 2 3 4 Pointy
How is a signal propagated in the heart?
From cell to cell
What does the heart form?
A functional syncytium
What allows the passage of ions between cells?
Gap junctions
What is the effect of the sympathetic nervous system on SA node action potential?
Sympathetic nervous system speeds up action potential
What is the effect of the parasympathetic innervation of the SA node?
Slows down action potentials
What is happening at phase 4 in the SA node?
Spontaneous depolarisation Slow influx leakage of Na+ Slow leakage of Ca2+
What is happening at phase 0 in the SA node?
Depolarisation Influx of Ca2+ Through L-type channels
What is happening at phase 3 in the SA node?
Repolarisation Efflux of K+ No Ca2+ comes in
What is happening at phase 0 in the AV node?
Rapid depolarisation Influx of Na+
What is happening at phase 1 in the AV node?
Partial repolarisation Na+ stops coming in K+ efflux
What is happening at phase 2 in the AV node?
Plateau phase K+ efflux Ca2+ influx
What is happening at phase 3 in the AV node?
Repolarisation K+ efflux No movement of Ca2+
What is happening at phase 4 in the AV node?
Ventricle diastole Pacemaker depolarisation Ions return to original location Via Na+/K+ATPase Na+/Ca2+ transporter Ca2+ ATP pump
What is the absolute refractory period?
A second action potential cannot be generated
What is the PQRST complex?
A heart beat seen on the ECG
What is P to R?
Atrial systole Ventricle diastole