Cardiac Electrophysiology Educypedia心脏电生理学 educypedia.ppt

A Case of Dizziness The EKG Physiology in action Objectives understand basic cardiac anatomy understand how cellular action potentials give rise to a signal that can be recorded with extracellular electrodes understand the path for action potential propagation through the heart understand the origin of the main phases of electrocardiogram (EKG) The Heart Currents and Voltages At rest, Vm is constant No current flowing Inside of cell is at constant potential Outside of cell is at constant potential Currents and Voltages During AP upstroke, Vm is NOT constant Current IS flowing Inside of cell is NOT at constant potential Outside of cell is NOT at constant potential More Currents and Voltages More Currents and Voltages The EKG Can record a reflection of cardiac electrical activity on the skin- EKG The magnitude and polarity of the signal depends on what the heart is doing electrically depolarizing repolarizing whatever the position and orientation of the recording electrodes Cardiac Anatomy Flow of Cardiac Electrical Activity Conduction in the Heart The Normal EKG Action Potentials in the Heart Start of EKG Cycle Early P Wave Later in P Wave Early QRS Later in QRS S-T Segment Early T Wave Later in T-Wave Back to where we started A Case of Sudden Death A Case of Sudden Death * * A 68 year old female arrives at the emergency room in an ambulance. That evening she had been feeling “weak and dizzy” after ingesting a handful of her “heart pills” and later passed out. Her heart rate was irregular but near 33 beats per minute. Her patient records and talks with her family revealed that she is being treated for poorly controlled hypertension and congestive heart failure. Her records indicate she has been prescribed the following medications: Doxazosin Avapro Tiazac Toprol Lasix Potassium supplements Digoxin Zyrtec, celebrex Her EKG records displayed several arrhythmias and while efforts at treatment were being made, she went into ventricular fibrillation. is a pu