ELEKTROFISIOLOGI

JANTUNG
DENNY AGUSTININGSIH
OCT 2008 DENNY AGUSTININGSIH 2
Two Types of Cardiac Muscle Cells

 Ordinary: Make up 95%- 99% of all heart

muscle cells.
Also called worker cells or contractile cells
Biochemically similar to red skeletal muscle

Slow to fatigue

 Specialized: make up remaining 1%-5%

Also called autorythmic or automatic cells
 Responsible for initiation and/or transportation of

electrical impulses through the heart

 pacemaker potential

OCT 2008 DENNY AGUSTININGSIH 3

The Pacemaker Cells

OCT 2008 DENNY AGUSTININGSIH 4

 MEKANISME DEPOLARISASI DAN REPOLASASI

+++++++++++++
---------------------
stimulasi Resting state
-/+ +/-
----++++++++++ ++++----------------
+++----------------- ----+++++++++++
Awal depolarisasi Awal repolarisasi

-----------------------
++++++++++++++
Depolarisasi sempurna
- Depolar karena masuknya ion
Ca, Na
- Repolarisasi karena keluarnya
ion Kalium dimudahkan oleh
parasimpatis
 K

0
Membrane Potential (mV)

K out
Ca ++ in

+
Threshold
Potential

-40 (T-type)
Ca

-60 Na

Spontaneous Time (msec)

Depolarization
CONDUCTING SYSTEM

Sinoatrial
Node

Atrioventricular
Node

OCT 2008 DENNY AGUSTININGSIH 7

OCT 2008 DENNY AGUSTININGSIH 8
Extrinsic Influences
 Autonomic nervous system: utk
menyelaraskan denyut cor
 Hormonal influences: tiroid meningkatkan
denyut cor
 Ionic influences
 Temperature influences: tubuh demam
denyut cor meningkat mrangsang
hipotalamus agar kerja cor cepat shg
membuang panas
OCT 2008 DENNY AGUSTININGSIH 9
 Cardiac Arrhythmias

 Tachycardia: Heart rate in excess of

100bpm
 Bradycardia: Heart rate less than 60 bpm
 Sinus arrhythmia: Heart rate varies 5%
during respiratory cycle and up to 30%
during deep respiration
 Premature atrial contractions: Occasional
shortened intervals between one
contraction and succeeding, frequently
occurs in healthy people
OCT 2008 DENNY AGUSTININGSIH 10
MYOGENIC CONDUCTION
Cardiac myocyte action potential:

OCT 2008 DENNY AGUSTININGSIH 12

AP-contraction relationship:
 AP in skeletal muscle is
very short-lived
 AP is basically over before
an increase in muscle
tension can be measured.

 AP in cardiac muscle is
very long-lived
 AP has an extra component,
which extends the duration.
 The contraction is almost
over before the action
potential has finished.
OCT 2008 DENNY AGUSTININGSIH 13
Mechanism of Cardiac Muscle Excitation,
Contraction & Relaxation

OCT 2008 Figure 14-11: Excitation-contraction coupling and relaxation in cardiac muscle
DENNY AGUSTININGSIH 14
 Relative
Refractory
period

Masa refraktor absolute:

1 saat ion Ca masuk otot,
+20 2 cor g bisa dirangsan
tujuannya agar cor tidak
ada fase tetani/ kejang
0
mV

3
Period of
Absolute Supranormal
Refractory excitability
4 period
-90 400
0 100 200 300

OCT 2008 DENNY AGUSTININGSIH 15

 Electrocardiogram (ECG)
 Composite of all action potentials of
nodal and myocardial cells detected,
amplified and recorded by electrodes on
arms, legs and chest

OCT 2008 DENNY AGUSTININGSIH 16

EKG:

OCT 2008 DENNY AGUSTININGSIH 17

 R

P T

Q
S

OCT 2008 DENNY AGUSTININGSIH 18

 R

P T

Q
S

OCT 2008 DENNY AGUSTININGSIH 19

 R 1 sec

P T

Q
S
0.5 Sec

OCT 2008 DENNY AGUSTININGSIH 20