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Cardiac Pacemakers
350px, Image showing the cardiac pacemaker or SA node, the primary pacemaker within the electrical conduction system of the heart. The muscle contraction, contraction of cardiac muscle (heart muscle) in all animals is initiated by electrical impulses known as action potentials that in the heart are known as cardiac action potentials. The rate at which these impulses fire controls the rate of cardiac contraction, that is, the heart rate. The cells that create these rhythmic impulses, setting the pace for blood pumping, are called pacemaker cells, and they directly control the heart rate. They make up the cardiac pacemaker, that is, the natural pacemaker of the heart. In most humans, the highest concentration of pacemaker cells is in the sinoatrial (SA) node the natural and primary pacemaker, and the resultant rhythm is a sinus rhythm. Sometimes a secondary pacemaker sets the pace, if the SA node is damaged or if the electrical conduction system of the heart has problems. Cardia ...
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Artificial Pacemaker
An artificial cardiac pacemaker (or artificial pacemaker, so as not to be confused with the natural cardiac pacemaker) or pacemaker is a medical device that generates electrical impulses delivered by electrodes to the chambers of the heart either the upper atria, or lower ventricles to cause the targeted chambers to contract and pump blood. By doing so, the pacemaker regulates the function of the electrical conduction system of the heart. The primary purpose of a pacemaker is to maintain an adequate heart rate, either because the heart's natural pacemaker is not fast enough, or because there is a block in the heart's electrical conduction system. Modern pacemakers are externally programmable and allow a cardiologist, particularly a cardiac electrophysiologist, to select the optimal pacing modes for individual patients. Most pacemakers are on demand, in which the stimulation of the heart is based on the dynamic demand of the circulatory system. Others send out a fixed rate of ...
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Right Atrium
The atrium ( la, ātrium, , entry hall) is one of two upper chambers in the heart that receives blood from the circulatory system. The blood in the atria is pumped into the heart ventricles through the atrioventricular valves. There are two atria in the human heart – the left atrium receives blood from the pulmonary circulation, and the right atrium receives blood from the venae cavae of the systemic circulation. During the cardiac cycle the atria receive blood while relaxed in diastole, then contract in systole to move blood to the ventricles. Each atrium is roughly cube-shaped except for an ear-shaped projection called an atrial appendage, sometimes known as an auricle. All animals with a closed circulatory system have at least one atrium. The atrium was formerly called the 'auricle'. That term is still used to describe this chamber in some other animals, such as the ''Mollusca''. They have thicker muscular walls than the atria do. Structure Humans have a four-chambered h ...
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Purkinje Fibers
The Purkinje fibers (; often incorrectly ; Purkinje tissue or subendocardial branches) are located in the inner ventricular walls of the heart, just beneath the endocardium in a space called the subendocardium. The Purkinje fibers are specialized conducting fibers composed of electrically excitable cells. They are larger than cardiomyocytes with fewer myofibrils and many mitochondria. They conduct cardiac action potentials more quickly and efficiently than any of the other cells in the heart's electrical conduction system. Purkinje fibers allow the heart's conduction system to create synchronized contractions of its ventricles, and are essential for maintaining a consistent heart rhythm. Histology Purkinje fibers are a unique cardiac end-organ. Further histologic examination reveals that these fibers are split in ventricles walls. The electrical origin of atrial Purkinje fibers arrives from the sinoatrial node. Given no aberrant channels, the Purkinje fibers are distinct ...
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Right Bundle Branch
The bundle branches, or Tawara branches, are offshoots of the bundle of His in the heart's ventricle. They play an integral role in the electrical conduction system of the heart by transmitting cardiac action potentials from the bundle of His to the Purkinje fibers. Structure There are two branches of the bundle of His: the left bundle branch and the right bundle branch, both of which are located along the interventricular septum. The left bundle branch further divides into the left anterior fascicle and the left posterior fascicle. These structures lead to a network of thin filaments known as Purkinje fibers. They play an integral role in the electrical conduction system of the heart by transmitting cardiac action potentials to the Purkinje fibers. Clinical significance When a bundle branch or their fascicles becomes injured (by underlying heart disease, myocardial infarction, or cardiac surgery), it may cease to conduct electrical impulses appropriately, resulting in alte ...
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Left Bundle Branch
The bundle branches, or Tawara branches, are offshoots of the bundle of His in the heart's ventricle. They play an integral role in the electrical conduction system of the heart by transmitting cardiac action potentials from the bundle of His to the Purkinje fibers. Structure There are two branches of the bundle of His: the left bundle branch and the right bundle branch, both of which are located along the interventricular septum. The left bundle branch further divides into the left anterior fascicle and the left posterior fascicle. These structures lead to a network of thin filaments known as Purkinje fibers. They play an integral role in the electrical conduction system of the heart by transmitting cardiac action potentials to the Purkinje fibers. Clinical significance When a bundle branch or their fascicles becomes injured (by underlying heart disease, myocardial infarction, or cardiac surgery), it may cease to conduct electrical impulses appropriately, resulting in alte ...
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Bundle Of His
The bundle of His (BH) or His bundle (HB) ( "hiss"Medical Terminology for Health Professions, Spiral bound Version'. Cengage Learning; 2016. . pp. 129–.) is a collection of heart muscle cells specialized for electrical conduction. As part of the electrical conduction system of the heart, it transmits the electrical impulses from the atrioventricular node (located between the atria and the ventricles) to the point of the apex of the fascicular branches via the bundle branches. The fascicular branches then lead to the Purkinje fibers, which provide electrical conduction to the ventricles, causing the cardiac muscle of the ventricles to contract at a paced interval. Function The bundle of His is an important part of the electrical conduction system of the heart, as it transmits impulses from the atrioventricular node, located at the anterior-inferior end of the interatrial septum, to the ventricles of the heart. The bundle of His branches into the left and the right bundle br ...
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Atrioventricular Node
The atrioventricular node or AV node electrically connects the heart's atria and ventricles to coordinate beating in the top of the heart; it is part of the electrical conduction system of the heart. The AV node lies at the lower back section of the interatrial septum near the opening of the coronary sinus, and conducts the normal electrical impulse from the atria to the ventricles. The AV node is quite compact (~1 x 3 x 5 mm).Full Size Picture triangle of-Koch.jpg
Retrieved on 2008-12-22


Structure


Location

The AV node lies at the lower back section of the

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Autonomic Nervous System
The autonomic nervous system (ANS), formerly referred to as the vegetative nervous system, is a division of the peripheral nervous system that supplies viscera, internal organs, smooth muscle and glands. The autonomic nervous system is a control system that acts largely unconsciously and regulates bodily functions, such as the heart rate, its force of contraction, digestion, respiratory rate, pupillary dilation, pupillary response, Micturition, urination, and sexual arousal. This system is the primary mechanism in control of the fight-or-flight response. The autonomic nervous system is regulated by integrated reflexes through the brainstem to the spinal cord and organ (anatomy), organs. Autonomic functions include control of respiration, heart rate, cardiac regulation (the cardiac control center), vasomotor activity (the vasomotor center), and certain reflex, reflex actions such as coughing, sneezing, swallowing and vomiting. Those are then subdivided into other areas and are also ...
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Parasympathetic Nervous System
The parasympathetic nervous system (PSNS) is one of the three divisions of the autonomic nervous system, the others being the sympathetic nervous system and the enteric nervous system. The enteric nervous system is sometimes considered part of the autonomic nervous system, and sometimes considered an independent system. The autonomic nervous system is responsible for regulating the body's unconscious actions. The parasympathetic system is responsible for stimulation of "rest-and-digest" or "feed and breed" activities that occur when the body is at rest, especially after eating, including sexual arousal, salivation, lacrimation (tears), urination, digestion, and defecation. Its action is described as being complementary to that of the sympathetic nervous system, which is responsible for stimulating activities associated with the fight-or-flight response. Nerve fibres of the parasympathetic nervous system arise from the central nervous system. Specific nerves include several ...
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Sympathetic Nervous System
The sympathetic nervous system (SNS) is one of the three divisions of the autonomic nervous system, the others being the parasympathetic nervous system and the enteric nervous system. The enteric nervous system is sometimes considered part of the autonomic nervous system, and sometimes considered an independent system. The autonomic nervous system functions to regulate the body's unconscious actions. The sympathetic nervous system's primary process is to stimulate the body's fight or flight response. It is, however, constantly active at a basic level to maintain homeostasis. The sympathetic nervous system is described as being antagonistic to the parasympathetic nervous system which stimulates the body to "feed and breed" and to (then) "rest-and-digest". Structure There are two kinds of neurons involved in the transmission of any signal through the sympathetic system: pre-ganglionic and post-ganglionic. The shorter preganglionic neurons originate in the thoracolumbar division o ...
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Depolarization
In biology, depolarization or hypopolarization is a change within a cell, during which the cell undergoes a shift in electric charge distribution, resulting in less negative charge inside the cell compared to the outside. Depolarization is essential to the function of many cells, communication between cells, and the overall physiology of an organism. Most cells in higher organisms maintain an internal environment that is negatively charged relative to the cell's exterior. This difference in charge is called the cell's membrane potential. In the process of depolarization, the negative internal charge of the cell temporarily becomes more positive (less negative). This shift from a negative to a more positive membrane potential occurs during several processes, including an action potential. During an action potential, the depolarization is so large that the potential difference across the cell membrane briefly reverses polarity, with the inside of the cell becoming positively char ...
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