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Saturday, 25 August 2012

CARDIAC PACEMAKER POTENTIALS


·         Seen in Pacemaker tissue a.k.a. Slow Response Fibres
o   SA node
o   AV node
o   His-Purkinje system
o   Coronary sinus
o   Pulmonary veins


·         Features
o   Action potentials in Pacemaker tissue is mainly due to Ca2+, with little contribution from Na+ (Therefore, there is no sharp/rapid depolarization spike in initial part of action potential)
o   In partially depolarized condition (i.e. -60mV) voltage-gated Na+ channels are in their inactive state; therefore do not take part in the action potential.
o   Characteristic feature- ‘Prepotential’ a.k.a. ‘Pacemaker potential/current
o   Atrial & ventricular muscle fibres do not have prepotentials; therefore they do not discharge automatically. (But, may discharge when injured/ abnormal).
o   RMP of pacemaker tissue (-60mV) is relatively more positive than that of atrial & ventricular muscle.
·         Two types of Ca2+ channels present
o   CaT (Transient) channels- opening mainly responsible for prepotential
o   CaL (Long-acting) channels- responsible for upstroke/phase 0





















·         Phases-
o   Phase 0- Upstroke/Impulse (due to slow Ca2+ current)
o   Phase 1- Repolarization (due to delayed rectifier K+ current)
o   Phase 2- Prepotential
§  Due to inward Ca2+ (major), inward Na+ (minor) & outward K+ (minor) current
· Main phase affected by autonomic nervous system.
§  Rise in intracellular Ca2+ mainly occurs due to-
·         Influx of Ca2+ via Ca2+ channels
·         Local Ca2+ release from sarcoplasmic reticulum (Ca-sparks)
  •      Regulation-

o   ANS control
§  Parasympathetic Nervous System





































§  Sympathetic nervous system




o   Temperature- Increased temperature causes increased firing


2 comments:

  1. I am a medical resident on cardiology and I also wrote a few words about cardiac pacemakers.

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