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Chapter III

Rhythmical excitation of
the heart

1. Electrical activity of the heart

2. Electrophysiological properties

3. Electrocardiogram (ECG)
1.Electrical activity of the heart

1) Resting membrane potential


2) Action potential
Types of cardiac cell

Working cells
Atrial myocytes
Ventricular myocetes
Conducting cells
SAN
AVN
His bundles
Purkinje fibers
Recall:
Outward current
o positive ion efflux or negative ion influx
o Bring membrane potential to
hyperpolarized state
Inward current
o Positive ion influx or negative ion efflux
o Bring membrane potential to
depolarization state
Ion Concentration
Ion Extracellular Intracellular E
(mmol) (mmol) (mV)
Na+ 145 10 +70

K+ 4 135 -94

Ca2+ 2 0.0001 +132

Cl- 104 9 -65


1)Resting membrane potential

Equilibrium potential: At rest,

the cardiac muscle membrane

is highly permeable to K+ and

almost impermeable to the

others. The contractile cell’s

resting potential is about –

90mV.
2)Action potential

a. Contractile cell b. autorhythmic cell


a. Contractile cells:
Phase 0
deploarization,
upstroke

From –90 mV to +30


mV

Duration 1–2ms,

APA ~120mV,

Speed of depolarization
800-1000V/s
Phase 1

Early rapid
repolarization

MP from +30 mV


to 0 mV

Duration ~10ms

Spike shape
Phase 2

Plateau, slow

repolarization

MP is ± 0mV

Duration 100-

150ms

Determine ADP
Phase 3

Terminal repolarization

 Late repolarization

MP from 0 mV to –90

mV

Duration 100-150ms
Phase 4

 Resting state

 MP -90mV
Ionic Mechanisms Underlying
the Action Potential
Phase 0

Voltage-gated sodium channel open


Phase 1

 Phase 1 (fast

repolarization phase 1)
 Sodium channel

inactivated
 Transient

outward current
activated.
Carried by

potassium
Phase 2

 Phase 2 (plateau phase)

 MP stayed at ± 0 mV

resulting in a plateau

 Inward component:

Ca2+

Outward component:
K+ efflux (Ik ) Ca2+ influx(ICa , L )
+
Phase 3

 Phase 3 (Repolarization)

 Ca2+ channel closed

 K+ channels are

activated
 Rapid K+ efflux

resulting in repolarization

bringing membrane

potential to its resting


Phase 4

MP tends to a stable state

 Na+/K+ pump is

activated

Ca2+ pump is

activated
summary
Depolarization is very rapid & is due to the
inward diffusion of sodium (0).

Repolarization begins with a slow outward


diffusion of potassium, but that is largely
offset by the slow inward diffusion of calcium
(1 & 2). So, repolarization begins with a plateau
phase. Then, potassium diffuses out much more
rapidly as the calcium channels close (3), and
the membrane potential quickly reaches the
'resting' potential (4), which is due to the Na+-
K+- pump.
b. Autorhythmic cells(sinus node)

Autorhythmic cells exhibit PACEMAKER


potentials.

The key to the rhythmical firing of


pacemaker cells is that, these cells will

slowly depolarize by themselves.


Phase 4  There are several kind of
currents that contribute to
spontaneously
depolarization at phase 4 in
pace-maker cells of SAN.
 An outward flow or "leak"
of K+ ions, declining with
the time goes on.
 An inward flow of Ca2+ .
 This relatively slow
depolarization continues
until the threshold potential
is reached ( -40 mV ~
-50mV.
Phase 0
The SA node do not have

fast sodium channels.


The depolarisation in phase

0 is mainly caused by a slow


influx of Ca2+ ions via
voltage-gated Ca2+ channels,
that opened when the
threshold was reached.
Phase 3
 The Ca2+ channels are
inactivated, soon after
they opened.
 Repolarization starts
when the K+ channels
open, allowing efflux of
K+ that renders the
interior of the cell
negative.
summary
Depolarization is due to the slow calcium
channels open (0).

Repolarization is due to the outward diffusion


of potassium (3).

During phase 4 there is a progressive reduction


in outward current of K+ and a steady inward
current of Ca2+.
important
Compare between ventricle cells and sinus node cells
Ventricle cells Sinus node cells
depolarization(phase 0) Na+ Ca 2+
Phase 1 K+ No
Phase 2(plateau) Ca 2+ No
Repolarization(phase 3) K+ K+
Phase 4 Na+-K+pump Ca 2+ K+
Speed of depolarization rapid slow
overshot +30 mV 0
Resting potential -90 mV No
Repolarizaiton potential NO - 60 mV
function contraction pacemaker
Overview of specific
events in the ventricular
action potential
Overview of specific events in
the action potential of
pacemaker cell
CHARACTERISTICS OF AP’S IN SKELETAL AND
CARDIAC MUSCLE CELLS