Electrical Properties of the Heart

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The Conducting System of the
Heart
Cardiac muscle cells, like other
electrically excitable cells
such as neurons and skeletal
muscle fibers, have a resting
membrane potential (RMP).
The RMP depends on a low
permeability of the cell
membrane to Na+ and Ca++
ions and a higher
permeability to K+ ions.
The Conducting System of the
Heart
It is a network of specialized
cardiac muscle cells that (1)
initiates and (2) distributes
electrical impulses.
It is composed of the following:
• 1- Sinoatrial (SA) node,
• 2- Atrioventricular (AV) node,
• 3- Conducting cells,
1- Sinoatrial (SA) node,
located in the junction between
SVC and posterior wall of Rt
atrium.
2- Atrioventricular (AV) node,
located in the membranous part
of interventricular septum.
3- Conducting cells, which
interconnect the two nodes and
distribute the contractile
stimulus throughout the
 Action Potentials (AP)
AP is the reverse of RMP and it is
the change in the permeability of the
cell membrane that produces AP. The
differences in AP between
myocardium and skeletal muscle
fibers are:
(A) AP in cardiac muscle last
longer (200-500 milli-seconds to
complete) than in skeletal muscle
cells (2 milli-seconds).
(B) AP in skeletal muscle fibers is
conducted along the length of a
single muscle fiber and not from fiber
to fiber, whereas ion cardiac muscle
• Also the rate of AP
propagation is slower in
cardiac muscle than in
skeletal muscle because
cardiac muscle cells are
smaller in diameter and
much shorter than skeletal
muscle fibers.
Although the gap junction of
intercalated disks allows
transfer of AP between
(D) In contrast to skeletal
muscle fibers, cardiac muscle
cells contract on its own, in
the absence of any neural or
hormonal stimulation. This
property is called
“Automaticity” or
Autorhythmicity.
(E) The resting potential of a
ventricular contractile cell is
approximately -90 mV,
Autorhythmicity of Cardiac Muscle:

• The heart is said to be

autorhythmic because it
stimulate itself (auto) to
contract at regular intervals
(rhythmic).
• If the heart is removed from the
body and maintained under
physiologic conditions with
proper nutrients and
temperature, it will continue to
• In the sino-atrial (SA) node,
specialized cardiac muscle cells,
called pacemaker cells, generate
AP spontaneously and at regular
intervals.
• These AP spread through the
conducting system of the heart to
other cardiac muscle cells, causing
voltage-gated Na+ ion channels to
open.
• As a result, AP are produced and the
cardiac muscle cells contract.
• The generation of AP in SA
node results when a
spontaneous developing
local potential, called
prepotential, reaches
threshold.
• The prepotential is caused
by changes in ion
movement into and out of
• Unlike other cardiac muscle
cells, the movement of Ca++ ions
to the pacemaker cells is
primarily responsible for the
depolarization phase of the AP.
• Repolarization occurs, as in
other cardiac muscle cells, when
the voltage-gated Ca++ ion
channels close and the voltage­
gated K+ ion channels open.
• After the RMP is reestablished,
production of prepotential starts
the generation of a next AP.
• An AP begins when the
membrane of the ventricular
muscle cell is brought to
threshold, usually at about
-75 mV.
• Threshold is normally
reached in a portion of the
membrane next to an
intercalated disc.
• The typical stimulus is the
excitation of an adjacent
Step 1:
The stage of rapid depolarization in
cardiac muscle cell resembles that in
skeletal muscle fiber.
At threshold, voltage-regulated sodium
channels open and the membrane
suddenly becomes permeable to Na+.
The result is rapid depolarization of the
sarcolemma.
The channels involved are called “fast
channels”, because they open
quickly and remain open fore only few
milliseconds.
Step 2:
The plateau: As the
transmembrane potential
approaches +30 mV, the
voltage-regulated sodium
channels close.
They will remain close and
inactivated until the membrane
potential reaches -60 mV.
As the sodium channels are
closing, voltage regulated
• These channels are called “slow
calcium channels” because they
open slowly and remain open foe
a relatively long period. This
portion of AP curve is called the
plateau.
• The presence of a plateau is the
major difference between APs in
cardiac muscle cells and skeletal
muscle fibers. In skeletal muscle
fibers, rapid depolarization is
Step 3:
Repolarization: As the
plateau continues, slow
calcium channels begin
closing and slow potassium
channels begins opening.
The result is a period of rapid
repolarization that restores
the resting AP.
The refractory period (The
period of
unresponsiveness):
As with skeletal muscle
conduction, for same time
after an AP begins the
membrane will not respond
normally to a second
stimulus. This time is called
In the absolute RP, the
membrane cannot
respond at all, because
the sodium channels are
either already open or
closed and inactivated. In a
ventricular muscle cell, the
absolute RP lasts
approximately 200 msec,
spanning the duration of the
 The absolute RP is followed
by a shorter (50 msec)
relatively RP. During this
period, the voltage-regulated
sodium channels are closed
but can open.
The membrane will respond to
a stronger-than-normal
stimulus by initiating another
AP.
 Note that:
I: Features of cells of conducting
system:
2. Smaller in size than the contractile
cells.
3. Contain very few myofibrils.
4. Cannot maintain a stable resting
potential.
II: Rate of spontaneous depolarization
differs in different areas of the
conducting system of the heart:
At SA node is about 80 to 100 beat per
minute (contraction).
At AV node 40 to 60 beat per minute
• III: SA node is regarded as a natural or
cardiac pacemaker.
• IV: The RMP for the SA cells is around
-60 mV, so they can be more easily
stimulated since they are in more critical
state than other cells of the conducting
system of the heart, and this is part of
the explanation why these cells have
automatic discharge of AP
(Autorhythmicity).