‫بسم هللا الرحمن الرحيم‬

Pacemaker potential

Abu ahmed
2019
 Pacemaker potential is the action
potential of the SA node.
 action potential of the SA node

characterized by prepotential.
 The prepotential triggers the next

impulse.
Causes of prepotential:
1. k+ efflux decreases, the
membrane begins to depolarize
this is a first part of prepotential.
2.Ca+2 channels open.
 They are two types of Ca+2
channels in the heart:-
◦ T (transient) channels.
◦ L (long- lasting) channels.
 Influx of ca++ due to T-channels
completes the prepotential.
 Influx of ca++ due to L-channels
produces the depolarization.
 Effects of Autonomic NS
 When cholinergic vagal fibers are
stimulated the membrane
becomes hyperpolarized. The
slope of prepotential is decreased
(more horizontal).
 the vagal effects achieved by M
2
receptors.
 Rate of spontaneous discharge
decrease then the heart rate
decrease.
 Sympathetic stimulation, makes The

slope of prepotential is increased

(more vertical).
 the sympathetic effects achieved by

B1 receptors.
 Rate of spontaneous discharge

increase then the heart rate increase.

Parasympathetic (vagus) nerves
(acetylcholine) promotes
opening of potassium channels;
reduces heart rate.
Sympathetic nerves (epinephrine

and norepinephrine) stimulate

opening of calcium channels;
increase heart rate.
Abnormal Pacemaker Function
 Bradycardia:

◦ heart rate less than 60b/min.

 Tachycardia:

◦ heart rate more than100b/min.

 Ectopic Pacemaker:
◦ Abnormal cells (foci)
◦ Generate high rate of action
potentials
◦ By pass conducting system
The Cardiac Cycle
 The Cardiac Cycle
 The normal heart rate is about 60-
100 beats/min.
 Each beat is regarded as one

cardiac cycle.
 Each cardiac cycle:

◦ involves phases of contraction

(systole) & relaxation (diastole)
◦ takes about 0.8 s.
 The cardiac cycle can be divided
into:-
1. Atrial diastole (0.7s).
2. Atrial systole (0.1s).
3. ventricular diastole (0.5 s)
4.Ventricular systole (0.3 s)
Atrial Systole
 About 70% of the ventricular filling
occurs passively , blood passes
from atria to ventricles through AV
valve.
 The atria contract to complete

ventricular filling.
 30% by atrial systole.
Atrial Systole
 Ventricular Systole
 Occurs immediately after atrial

systole.
 When the ventricles start to

contract, the pressures inside

them start to rise.
 When the ventricular pressure
exceeds atrial pressure, the AV
valves close.
 This results in the first heart

sound.
 The AV valves bulge into the

atria so there is small & sharp

rise in its pressure.
 The ventricles continue to
contract.
 The pressures inside them
continue to rise
 While all valves are closed
 This is called isovolumetric
contraction phase (0.05s)
When the pressure in the:-
left ventricle reaches 80
mmHg
right ventricle reaches 10
mmHg
The semilunar valves open.