By Jose Jalife, Mario Delmar, Justus Anumonwo, Omer Berenfeld, Jerome Kalifa
This e-book interprets primary wisdom in easy cardiac electrophysiology from the bench to the bedside. Revised and up to date for its moment variation, the textual content bargains new insurance of the molecular mechanisms of ion channel habit and its legislation, complicated arrhythmias, and the broadening roles of units and ablation. transparent, ordinary motives are illustrated by way of abundant diagrams to make the fabric obtainable to the non-specialist.
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Additional info for Basic Cardiac Electrophysiology for the Clinician 2nd Edition
In this section, we describe some of the major features in the action potentials of sinoatrial (SA) and atrioventricular (AV) nodal as well as Purkinje cells. Sinoatrial Nodal Cells Cardiac activation normally starts in the SA node. 18), and their intrinsic frequency of discharge is, under normal conditions, faster than that of any other pacemaker in the heart. In true pacemaker cells of the SA node, the diastolic membrane potential does not remain constant. , the maximum diastolic potential) to the threshold for activation, thus eliciting a new active response.
Only potassium conductances remain active; consequently, the membrane potential returns relatively rapidly toward EK. The delayed rectifier currents (IKr and IKs) tend to close as the cell repolarizes, and thus the inwardrectifier current (IK1) predominates. Phase 4: Diastolic Potential In atrial and ventricular muscle cells, the resting potential remains constant throughout the diastolic interval. In these cell types, the inward-rectifier current IK1 remains the dominant conductance at rest and it is largely responsible for setting the resting membrane potential.
The outward currents also participate in the RRP. As discussed earlier, the total membrane current results from the balance between the inward and outward currents. Outward currents oppose the depolarizing influence of inward currents. During repolarization (and briefly during diastole) the delayed rectifier channels are conductive. To re-excite the cell, the depolarizing current must overcome the repolarizing influence of the outward currents. Thus, the duration of the RRP is determined in a complex manner by the time course or reactivation of the inward currents as well as by the time course of deactivation (or “closure”) of the delayed rectifier outward conductance.