心肌细胞跨膜电活动及心肌的电生理特征(英文).ppt

Factors Affecting Autorhythmicity Maximal repolarization potential Threshold potential The rate of phase 4 spontaneous depolarization Sinus Bradycardia（窦性心动过缓） Pacemaker Conductivity（传导性） Gap junction SA node Atria A-V node 0.05 m/s 0.4 m/s 0.02~0.05 m/s His bundle Purkinje fiber Ventricle 1.2~2.0 m/s 2.0~4.0 m/s 1.0 m/s Conducting velocity Atrioventricular delay（房室延搁）: Asynchronization of atrial and ventricular depolarization to provide adequate cardiac output Factors Affecting Conductivity Structural factors Diameter of cardiac cells Gap junctions at Intercalated disk Physiological factors The velocity and amplitude of phase 0 depolarization Excitability of adjacent region First Degree AV Block Definition: 1AVB is a rhythm in which the electrical impulse which leaves the SA node and travels through the atria, AV node, Bundle of His to purkininjie fibers is slowed down and takes longer than normal to arrive at its destination. The normal PR interval is 0.12- 0.20 seconds. A 1AVBT is greater than 0.20 seconds. The cause ranges from coronary heart disease, inferior wall MIs, hyperkalemia, congenital abnormalities, and medications such as quinidine, digitalis, beta blockers, and calcium channel blockers. Second degree AV Block type 1 (Mobitz) Definition: Second degree AV block is also known as Second Degree Type I, Mobitz I, or Wenckelbach. This arrhythmia is characterized by a progressive delay of the conduction at the AV node, until the conduction is completely blocked. This occurs because the impulse arrives during the absolute refractory period, resulting in an absence of conduction, and no QRS. The next P wave occurs and the cycle begins again. Possible causes are acute inferior wall myocardial infraction, digitalis, beta blockers, calcium channel blockers, rheumatic fever, myocarditis, or excessive vagal tone. Mobitz II is characterized by 2-4 P waves before each QRS. The PR of the conducted P wave will be constant for each