三尖瓣

Chordae tendinae
腱索
二尖瓣
( 憎帽瓣 )
 房室結 希斯氏束
電傳導系統

竇房結 Left bundle branch

左束枝

結間路徑 Left posterior fascicle

左後分枝

Right bundle branch

右束枝

浦金氏纖維 left anterior fascicle

左分枝
跳動速率
 The action potential of a
myocardial pumping cell.

The rapid opening of voltage-gated

sodium channels is responsible for
the rapid depolarization phase.

The prolonged “plateau” of

depolarization is due to the slow
but prolonged opening of
voltage-gated calcium channels
PLUS
closure of potassium channels.

Opening of potassium
channels results in the
repolarization phase.

Figure 12-13
 The action potential of an
autorhythmic cardiac cell.

Sodium ions “leaking” in through

the “funny” channels
PLUS
calcium ions moving in through
the T channels cause a
threshold graded depolarization.

The rapid opening of voltage-gated

calcium channels is responsible
for the rapid depolarization phase.

Reopening of potassium channels

PLUS
closing of calcium channels
are responsible for the
repolarization phase.

Figure 12-14
Note the much smaller scale for the ECG potential.
1903
Einthoven 荷
標準誘導 ( 雙極標準誘導
)
aVR=3/2VR, aVL=3/2VL, aVF=3/2VF
雙極標準誘導 單極肢誘導

II = III + I aVR + aVL + aVF = 0

I=VL-VR=2/3(aVL-aVR)
II =VF-VR=2/3(aVF-aVR)
III =VF-VL=2/3(aVF-aVL)

六軸系統 額平面 ( frontal plane

胸誘導
Horizontal plane
水平平面
間段

間期
0.04 × 23 = 0.92
60 ÷ 0.92 = 62 bpm
心房去極化
心室中膈去極化
心尖及早期心室去極化
後期心室去極化
 3
1

2
3 2

1
電力位置
心軸
+53°
 -
+
Now translate this to the
ECG. If it is positive in I
and negative in aVF, it is
a left axis.
Then look at II, if it is also
negative, you have LAH.
simple

-30º to -90º
 極端軸偏位 左軸偏位

正常軸
右軸偏位
Left axis deviation Right axis deviation

Left anterior hemiblock, left ventricular hypertrophy,

Right ventricular hypertrophy, left posterior hemiblock, …