Cardiovascular System-

Electrophysiology

Manipal College of Pharmaceutical Sciences

Question to be answered
• Explain cardiac conduction system and
generation of action potential in cardiac
contractile fibers(5).

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Cardiac Muscle Tissue

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Autorhythmic Fibers

– Specialized cardiac muscle fibers

– Self-excitable
– Repeatedly generate action potentials that trigger
heart contractions
– 2 important functions
1. Act as pacemaker
2. Form conduction system

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 Conduction system

1. Begins in Sinoatrial
(SA) node in right atrial
wall
• SA node cells do not
have stable resting
potential
• They repeatedly
depolarize to reach
threshold
• Pacemaker potential
• Action potential
• Atria contact

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UN I VE RS I Y
2. AP reaches AV node located in inter-atrial septum
•At AV node, AP slows due to difference in cell structure in
AV node
•Atria empties to ventricle
3. AP enters AV bundle or bundle of his.
•This bundle is only site where AP can conduct from atria
to ventricles
4. Right and left bundle branches
5. Purkinje fibers conduct AP to remainder of ventricular
myocardium. Ventricles contract

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 Frontal plane

Left atrium
Right
Right atrium
atrium

1 SINOATRIAL (SA) NODE

2 ATRIOVENTRICULAR
(AV) NODE

3 ATRIOVENTRICULAR (AV)
BUNDLE (BUNDLE OF HIS)
Left ventricle
4 RIGHT AND LEFT
BUNDLE BRANCHES

Right
Right ventricle
ventricle

5 PURKINJE FIBERS

Anterior view of frontal section

 22 Plateau (maintained depolarization) due to Ca inflow
2+

when voltage-gated slow Ca channels open and

2+

+ 20 K+ outflow when some K+ channels open

–20 33 Repolarization due to closure

of Ca2+ channels and K+ outflow
Membrane –40 11 Rapid depolarization due to when additional voltage-gated
potential (mV)
Na+ inflow when voltage-gated K+ channels open
– 60 fast Na+ channels open

– 80

–100
0.3 sec

Depolarization Repolarization

Refractory period

Contraction

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Electrocardiogram
• ECG or EKG
• Composite record of
action potentials produced
by all the heart muscle
fibers
• Compare tracings from
different leads with one
another & with normal
records
• 3 recognizable waves
– P, QRS, & T
• P-Q, Q-T interval, S-T
segment

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 Electrical events of ECG

1. Begins in Sinoatrial
(SA) node in right atrial
wall
• SA node cells do not
have stable resting
potential
• They repeatedly
depolarize to reach
threshold
• Pacemaker potential
• Action potential
• P Wave in ECG

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UN I VE RS I Y
2. AP reaches AV node
located in inter-atrial septum
•At AV node, AP slows due
to difference in cell structure
in AV node
•Atria empties to ventricle
•Atrial Systole
3. AP enters AV bundle or
bundle of his.
•This bundle is only site
where AP can conduct from
atria to ventricles
•Ventricular depolarization
•QRS complex

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UN I VE RS I Y
4. Ventricular systole
•S-T segment
5. Repolarization of
ventricular fibers
•T wave

•P-Q interval- conduction

time from beginning of atrial
excitation to beginning
ventricular excitation
•Q-T interval-beginning of
ventricular depolarization to
end of ventricular
repolarization

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UN I VE RS I Y
 1 Depolarization of atrial
contractile fibers
produces P wave

6 Ventricular
6 diastole
(relaxation) P

Action potential
in SA node
0 0.2 2 Atrial systole
(contraction)
Seconds

P
0 0.2 0.4 0.6 0.8
Seconds
5 Repolarization
5 of
ventricular contractile 0 0.2
fibers produces T Seconds
wave
3 Depolarization of
ventricular contractile
fibers produces QRS
complex
T
P R

4 Ventricular P
0 0.2 0.4 0.6 systole
Seconds (contraction)
Q
S

0 0.2 0.4
Seconds
P

0 0.2 MANIPAL
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