ECG and the Heart’s Internal Conduction System Guided Notes Name:________________________ Do Now What is an action potential and where do they occur? Intrinsic conduction system _______________ is the heart’s natural pacemaker. ◦ Impulse travels throughout the ____________ and to the ________________ ◦ _______________________________________ _______________________________to allow atria to finish contracting The ______________ (aka bundle of His) transmits the impulse to the _______________________ and ______________________________________. Interestingly, all the cells of the conduction system are _______________________________. That is, all will depolarize at a certain rate. The __________________ has the fastest rate of depolarization, though, so it sets the pace for the entire heart. What is the function of - AV node - Gap junctions Travels cell-to-cell through __________ _________________ in intercalated discs – another unique feature of cardiac muscle ◦ Quick Review – Intrinsic Conduction System It depolarizes ~75 times / min, to start each heartbeat. ◦ These bundles and fibers speed the transmission of the impulse throughout the ventricles, to coordinate ventricular contraction - SA node - Purkinje fibers Name 3 differences between cardiac and skeletal muscle contraction & explain why each is important to cardiac function. ECG An electrocardiogram (ECG or EKG) records the electrical current through the heart. A normal ECG has three distinct waves: ◦ P wave – atrial depolarization ◦ QRS complex – ventricular depolarization AND atrial repolarization ◦ T wave – ventricular repolarization ECG Questions What is responsible for the delay between P wave and QRS complex? What is responsible for the delay between T wave and next P wave? Examine this normal ECG. When would the ventricles be in systole? When would they be in diastole? When would the heart sounds occur, and what do the heart sounds correspond to? ECG abnormalities Examine these ECG readouts, and identify how they differ from a normal ECG. a) b) c) d) Descriptors – Name AV block Atrial fibrillation Tachycardia Bradycardia Characteristic ECG In severe cases, there is NO relationship between P waves and QRS complex. QRS still occurs due autorhythmic cells in AV node, but at a slower rate. Wavy baseline, no regular p waves QRS normal shape but occurs randomly Looks messy Heart beats faster than normal (more than 100 bpm) Heart beats slower than normal (less than 60 bpm) Cause(s) Damage to AV node, such as from reduced blood flow (ischemia) or fibrosis. Treatment: dual chamber artificial pacemaker- one that ‘listens’ to the SA node and sends a signal to the AV node Heart is doing uncoordinated, ineffective contraction due to lack of blood, excess alcohol, or infection Exercise, drugs Many conditions, including heart damage, medications, etc, Regulation of Heart Rate Earlier, we said that the SA node depolarizes at a rate of ~75 beats per minute, and that this acts as a pace maker for heart contraction. Does this mean our hearts always beat at ~75 bpm? What are the two branches of the autonomic nervous system, and how do they affect heart rate? Other factors that influence heart rate Age (fastest in fetus, young children) Gender (faster in females) Temperature (faster in heat) Exercise (faster with exercise) Ions imbalances & medicines (faster or slower) Weak / damaged heart (can be either faster / slower)