CONDUCTING SYSTEM OF THE

HEART
BERNARD MBITHI
 Electrical Events

• The ability of cardiac muscle to

depolarize and contract is intrinsic i.e it
does not depend on the nervous system.
• A healthy heart is supplied with
autonomic nerve fibers that can alter the
basic rhythm of heart activity set by
intrinsic factors.
 The Intrinsic Conduction System
• The independent, but coordinated, activity
of the heart is a function of
• the presence of gap junctions,
• the activity of the heart’s conduction
system-consists of non-contractile
cardiac cells specialized to initiate and
distribute impulses throughout the
heart, so that it depolarizes and
contracts in an orderly, sequential
manner
 The intrinsic conduction system
• The autorhythmic cells making up the
intrinsic conduction system do not
maintain a stable resting membrane
potential.
• Instead, they have an unstable resting
potential that continuously depolarizes,
drifting slowly toward threshold.
 The intrinsic conduction system
• These spontaneously changing
membrane potentials, called pacemaker
potentials or prepotentials, initiate the
action potentials that spread throughout
the heart to trigger its rhythmic
contractions
 The intrinsic conduction system

• The pacemaker potential is due to the

special properties of the ion channels in
the sarcolemma.
• In these cells, hyperpolarization at the
end of an action potential leads to both
closing of K+ channels and opening of
slow Na+ channels.
 The intrinsic conduction system
• The Na+ influx alters the balance between
K+ loss and Na+ entry, and the membrane
interior becomes less and less negative
(more positive).
• Ultimately, at threshold (approximately –
40 mV), Ca2+ channels open, allowing
explosive entry of Ca2+ from the
extracellular space.
 The intrinsic conduction system

•  Thus, in autorhythmic cells, it is the

influx of Ca2+ (rather than Na+) that
produces the rising phase of the action
potential and reverses the membrane
potential.
 The intrinsic conduction system

•  The total time between initiation of an

impulse by the SA node and
depolarization of the last of the
ventricular muscle cells is approximately
0.22 s (220 ms) in a healthy human
heart.
 The intrinsic conduction system
•   Ventricular contraction almost immediately
follows the ventricular depolarization wave.
A contraction begins at the heart apex and
moves toward the atria, following the
direction of the excitation wave through the
ventricle walls. This ejects some of the
contained blood superiorly into the large
arteries leaving the ventricles.
   
 The intrinsic conduction system

• Although the SA node normally drives

the heart at a rate of 75 beats per
minute
• The cardiac conduction system
coordinates and synchronizes heart
activity.
   
 The Heart: Conduction System
• The heart pumps blood through the body
• This is accomplished by contraction and
relaxation of the cardiac muscle tissue in
the myocardium layer.
 Conduction System

• Cardiac conduction system: The electrical

conduction system controls the heart
rate
• This system creates the electrical
impulses and sends them throughout the
heart.
 Components of the conduction system
• Sinoatrial Node - located in back wall of the
right atrium near the entrance of vena cava
– initiates impulses 70-80 /min-establishes
basic rhythm of the heartbeat
– impulses move through atria causing the
two atria to contract. At the same time,
impulses reach the second part of the
conduction system
Components of the conduction system
• AVN -located in the bottom of the right
atrium near the septum
– cells in the AV node conduct impulses
more slowly, so there is a delay as
impulses travel through the node
– this allows time for atria to finish
contraction before ventricles begin
contracting
Septum
 Atrioventricular Bundle
• A.K.A. “Bundle of His”
• From the AV node,
impulses travel through to
the right and left bundle
branches
• These branches extend to
the right and left sides of
the septum and bottom of
the heart.
 Atrioventricular bundle
– These branch a lot to form the Purkinje
fibers that transmit the impulses to the
myocardium (muscle tissue)
– The bundle of His, bundle branches and
Purkinje fibers transmit quickly and
cause both ventricles to contract at the
same time
 Atrioventricular bundle

• As the ventricles contract, blood is forced

out through the semilunar valves into
the pulmonary trunk and the aorta.
• After the ventricles complete their
contraction phase, they relax and the SA
node initiates another impulse to start
another cardiac cycle.
1 - Sinoatrial node (SA node)
2 - Atrioventricular node
3 – Bundle of His
4 - Right & Left Bundle
Branches which lead to
Purkinje Fibers
 Cardiac Physiology Electrocardiography Diagnosis

Sinoatrial Node

Atrioventricular Node
Cardiac Physiology Electrocardiography Diagnosis

P T

Q
S
Cardiac Physiology Electrocardiography Diagnosis

P T

Q
S
Cardiac Physiology Electrocardiography Diagnosis

R
1 sec

P T

Q
S

0.5 Sec
 Electrocardiogram (ECG)
• In a normal ECG:
• P wave: atrial depolarization
• PR interval: impulse conduction through
the AV node
• QRS complex: ventricular depolarization.
• T wave: ventricular repolarization.