Electrical Activity of the Heart

V. Sutarmo Setiadji
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Cardiac pacemaker activity is
regulated by at least five different
classes of ion channels and by the
opposing influence of sympathetic
and parasympathetic stimulation.
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Resting membrane potential of the
heart muscle and SA node
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Spontan depolarization = prepotential
Normal pace-maker: SA node
- From SA node atrial myocardium
(3 preferential pathways = Bachmann
bundles)
- AV node
- His bundle
- Purkinje
fibers
- Ventricular
myocardium
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Heart:
Two syncytium

- Atriums

- Ventricles

Work as two
muscles

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Action potential of pace maker cell
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Depolarization
- Intracellular
become positive
- Extracellular
become negative
ECG records extra-
cellularly
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ECG Analysis (Normal ECG)
- Rhythm P is followed by QRS complex
sinus rhythm
- Frequency: RR interval: 25/RR X 60
1500 divides by RR
- P duration and amplitude
- PR interval
- QRS duration < 0.1 s
- ST segment depressed/elevated
- QT varies by heart rate corrected by RR
- QTc = QT/VRR = (normally 0.4 s)
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1. Basic concept of normal Electrophysiology and conduction
2. Transmission of cardiac impulse
a. Phases and ion movement
b. Relative and absolute refractory periods
c. Conduction velocity
3. Action potential
4. Specialized conducting systems
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