心血管系统概述心肌细胞电活动教学课件.ppt

Autorhythmicity SA node 100 times/min AV node 50 times/min Bundle of His 40 times/min Purkinje fibers 25 times/min Normal pacemaker（正常起搏点） SA node Latent pacemaker （潜在起搏点） (Ectopic pacemaker [异位起搏点] under pathophysiological conditions) AV node Bundle of His Purkinje fibers The mechanisms of SA node to control latent pacemakers Capture（夺获） Overdrive suppression（超速抑制） Factors Affecting Autorhythmicity Maximal repolarization potential Threshold potential The rate of phase 4 spontaneous depolarization Sinus Bradycardia（窦性心动过缓） Pacemaker 1. Tom, an 80 yr old male, presents to his physician with a resting heart rate of 35 bpm. You classify his heart rate as: A. Normal B. Bradycardia C. Tachycardia 2. His pacemaker is most likely located at the: A. Sinoatrial node B. Atrial-ventricular node C. His Bundle-Purkinje 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