Circulatory System: The Heart

Electrical and contractile activity of heart

ECG

19-1

Cardiac Rhythm
Systole: ventricular contraction
Diastole: ventricular relaxation
Sinus rhythm: triggered by the SA node
adult at rest is 70 to 80 bpm
Premature ventricular contraction (extrasystole)
caused by hypoxia, electrolyte imbalance, caffeine,
stimulants, stress
Arrhythmia: abnormal cardiac rhythm
ventricular fibrillation is a serious arrhythmia
caused by electrical signals arriving at different
times to different regions of myocardium

19-2

Depolarization of SA Node
SA node: no stable resting membrane potential
Pacemaker potential
gradual depolarization (slowly more positive) from -60 mV
a slow, steady inflow of Na+ without a compensating
outflow of K+

Na+ enters through a special type of channel found only in

pacemaker cells (particularly SA node)
As near threshold, a special transient, fast-opening,
voltage-gated calcium channel on pacemaker cells opens

19-3

Depolarization of SA Node
Action potential
occurs at threshold of -40 mV
slow-entry Na+ channels close

special voltage-gated calcium channels open which are slowopening and long-lasting

produces slowly rising, depolarizing phase; stops at 0 mV

Nodal cells propagate action potentials more slowly than

other cardiac cells; slow transmission through A.V. node
repolarizing phase starts at 0 mV (the peak)
K+ channels open, K+ pours out
As nodal cell becomes more negative, K+ channels gradually close
special, slow-entry sodium channels gradually open again
pacemaker potential starts over.

19-4

SA Node Potential
+10

Membrane potential (mV)

0
10

K+
outflow

slow
Ca2+
inflow

20
30

Action
potential

Threshold

40
Ca2+
inflow

50

60

Pacemaker
potential

slow Na+
inflow

70

.4

.8

1.2

1.6

Time (sec)
19-5

Pacemaker Rates of Conduction System

Each depolarization of SA node creates one
heartbeat: sends signals through the whole
conduction system
SA and AV node cells have same shaped action
potentials but SA node cells reach threshold
faster
Thus, SA node initiates heart beat before AV
node could
Other cells of conducting system have inherent
pacemaker rates which are lower than SA node
19-6
pacemaker rate

Excitation of Myocardium
Cardiocytes have stable resting potential (-90 mV)
Depolarization
stimulus opens voltage-gated Na+ gates, Na+ enters,
membrane depolarizes to threshold
reaching threshold voltage, opens more Na+ gates in
cardiocytes and triggers a positive feedback cycle
action potential peaks at +30 mV
Na+ gates inactivate quickly (does not necessarily close)
excitation opens the slow-opening, L-type calcium
channels on the large T tubules
allow a small amount of Ca2+ to enter from outside cell
19-7

Contraction of Myocardium
Long plateau - sustains contraction
extracellular Ca2+ binds to receptors of ligand-gated Ca2+
channels on SR
SR Ca2+ channels open and release Ca2+ into cell cytosol
calcium induces calcium release
second wave of Ca2+ from SR binds to troponin and triggers
contraction just as in skeletal muscle
exposes actin sites which can bind to myosin
depolarization occurs right before actual heart muscle
contraction begins.
In cardiac muscle, the depolarization is prolonged for a long
period of 200 to 250 msec as compared to 2 msec in skeletal
muscle and neurons (shown by a plateau)
because calcium is around longer, cardiocyte is more positive
and membrane is depolarized longer at plateau value even 19-8
though some K+ starts to leak out.

Contraction of Myocardium
Long refractory period The long action
potential plateau means cardiocytes have a
long refractory period, which means only one
action potential per muscle contraction of
cardiocyte (multiple action potentials during
contraction would interfere with contraction).
Repolarization L-type Ca2+ channels close,
one of two types of K+ channels open (like in
skeletal muscle and nerve cells), K+ leaves
cell, membrane voltage drops rapidly, and
muscle tension declines soon afterward (due 19-9

Action Potential of Ventricular

Cardiocyte
1) Na+ gates open
2) Rapid
depolarization

3) Na+ gates
inactivate
4) L-type Ca2+
channels open,
contraction begins
5) L-type Ca2+
channels close,
K+ channels open

19-10

Electrocardiogram (ECG)
Composite of all action potentials of nodal and
myocardial cells detected, amplified and recorded by
electrodes on arms, ankles and chest

19-11

ECG
P wave
SA node fires, atrial depolarization
atrial systole (atrias contract)

QRS complex
ventricular depolarization
(atrial repolarization and diastole - signal
obscured by ventricular activity)

ST segment - ventricular systole (ventricles

contract)

T wave
ventricular repolarization immediately before
diastole (right before ventricles relax)

19-12

Normal Electrocardiogram (ECG)

19-13

Diagnostic Value of ECG

Invaluable for diagnosing abnormalities in
conduction pathways, MI, heart
enlargement and electrolyte and hormone
imbalances

19-14

ECGs, Abnormal

Extrasystole: note inverted QRS complex, misshapen QRS

and T and absence of a P wave preceding this contraction.
19-15

ECGs, Abnormal

No pumping action occurs

19-16