INTERNATIONAL

UNIVERSITY

Conduction System of the Heart

Asst.Prof. S Sophat
 Conduction System of the Heart
 Cardiac muscle has an intrinsic
rhythmicity that allows the heartbeat
to originate in and be conducted
through the heart without extrinsic
stimulation.
 Specialized strands (fibers) of
interconnecting cardiac muscle tissue
that coordinate cardiac contraction
constitute the conduction system.
 Conduction System of the Heart
 The conduction system enables the
cardiac cycle, which refers to the
events surrounding the filling and
emptying of the chambers of the
heart.
 The conduction system consists of
specialized tissues that generate
and distribute electrical impulses
through the heart.
 Conduction System of the Heart
The components of the conduction system
are the:
 sinoatrial node (SA node),
 atrioventricular node (AV node),
 atrioventricular bundle (bundle of His
[pronounced "hiss"]),
 right & left bundle branches and
 conduction myofibers (Purkinje [pur-kin je]
fibers).
 None of these structures are macroscopic,
but their locations can be noted.
 Conduction System of the Heart

 The SA node, or pacemaker, is

located in the posterior wall of the
right atrium.
 The SA node initiates the cardiac
cycle by producing an electrical
impulse that spreads over both atria,
causing them to contract
simultaneously and force blood into
the ventricles.
 Conduction System of the Heart
 The basic depolarization rate of the
SA node is 70-80 times per minute.
 The impulse then passes to the AV
node, located in the inferior portion of
the interatrial septum.
 From here, the impulse continues
through the atrioventricular bundle
(bundle of His), located at the top of the
interventricular septum.
 Conduction System of the Heart
 The atrioventricular bundle divides
into right and left bundle branches,
which are continuous with the
conduction myofibers (Purkinje
fibers) within the ventricular walls.
 Stimulation of these fibers causes the
ventricles to contract simultaneously.
 Conduction System of the Heart
 Contraction of the ventricles is
referred to as systole .
 Systole, together with the tension of
the elastic fibers and contraction of
smooth muscles within the systemic
arteries, accounts for the systolic
pressure within arteries.
 Conduction System of the Heart
 Ventricular relaxation is called
diastole .
 During diastole, the diastolic
pressure within arteries can be
recorded.
 The heartbeat can vary by as much
as 20 or 30 beat per minute in 24
hours, but the heart maintains an
average of about 70 beats per minute
during a day.
 Conduction System of the Heart
 Blood pressure recorded at 120 over

80 in the morning can rise to 140 over

100 by evening.
 The normal body temperature of
98.6°F (37°c) will fluctuate between
97° (36.1°c) and 99°F (37.2°c) over a
24 hour period.
 Conduction System of the Heart
 Although the heart does have an
innate (inborn ,natural) contraction
pattern, it is also innervated by the
autonomic nervous system in order
to respond to the everchanging
physiological needs of the body.
 The SA and AV nodes have both
sympathetic and parasympathetic
innervation.
 Conduction System of the Heart
 Sympathetic stimulation
accelerates the heart rate and
dilates the coronary arteries,
enabling the heart to meet its own
increased metabolic demands as
well as those of the rest of the body.
 Parasympathetic stimulation has
the opposite effect.
 Conduction System of the Heart
 Sympathetic innervation is through
fibers from the cervical and upper
thoracic ganglia.
 Parasympathetic innervation is through
branches of the vagus nerves.
 Branches from the right vagus
innervate the SA node, and branches
from the left vagus innervate the AV
node.
 Conduction System of the Heart
 Cardiac output is the volume of
blood ejected by the heart into the
systemic circulation each minute.
 It is determined by multiplying the
stroke rate, or heart rate, by the
stroke volume.
 The stroke volume is the amount of
blood pumped from the heart into
systemic circulation with each
ventricular contraction, which
amounts to about 70 ml of blood.
 Conduction System of the Heart
 A normal resting cardiac output ranges
between 4.2 and 5.6 liters per minute.
 Exercise
increases the heart rate, as do
the hormones epinephrine and thyroxine.
 Atropine, caffeine, and camphor are
drugs that have a stimulatory effect.
 Blood pressure and body temperature
also have a profound effect on the
heart rate.
THANK YOU