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Physiology Lecture - Dr. Dominguez: Slow Fast
Physiology Lecture - Dr. Dominguez: Slow Fast
MECHANISMS OF ARRHYTHMIAS
I.
Ectopic pacemakers:
a. Enhanced own rhythmicity: e.g. sinus
tachycardia (automaticity of the SA
node, P-waves are present)
b. Depressed rhythmicity of higher-order
pacemakers
c. Block in pathways between ectopic
focus and pacemaker (e.g. 3rd degree
AV block, COMPLETE AV block. There is
a P wave but the QRS do not follow.
The QRS is fired by the purkinje fibers,
so there are more P-waves than
QRSs.)
fast
NORMAL
REENTRY
impulses cannot
travel going down, but can go up.
Short effective refractory period
Results in AV node reentry in circuit.
Prolonged conduction time
Triggered automaticity:
-dependent on ATP
2mechanisms:
a. Early After Depolarization: occurs
midway between plateau phase and
initial part of phase 3 of the ventricular
action potential. Pathophysiology:
reactivation of calcium channels. Usually
in ischemias due to calcium overload.
When heart rate is slow.
b. Delayed after depolarization: occurs
after phase 3, delayed calcium entry,
occurs in patients with tachycardia.
II.
REENTRY
Arrhythymia
Sinus bradycardia
Pathoph
decreased SA node firi
Sinus tachycardia
Note takers:
Dumaup, David
Pagbilao, Vic
Tulas,
Ulysses