Special Conductive System of Heart

By: Azher Syed

 Special Conductive System of Heart

• Introduction
• Pacemaker
• S.A. Node
• A.V. Node
• Internodal Atrial Pathways
• Bundle Of His/ Atrioventricular Bundle
• Purkinje system
• ECG
• Cardiac Conduction System
 Introduction
• Heart
 Contracting & Conducting fibers.
 Special tissue that produces & sends electrical
impulses.
• Cells present in the conductive system are:
– P cells
– Purkinjee cells
– Transitional cells
– Working myocardial cells
 Introduction contd…

Why is this a Special Conductive System?

Conductive system is organized in such a

way, that the cardiac impulse are not
supposed to be carried too rapidly from
atria to ventricles. Because of intercalated
disc & branched fibres.
 Pacemaker
• What exactly is a pacemaker?
– These are certain tissues which are
responsible for generation & conduction of
heart beat. They are
• 1. SAN
• 2. AVN
• 3. Bundle of HIS Or Atrioventricular bundles
• 4. Purkinje fibers
 Pacemaker contd…

• Pacemaker potential:
– It is mainly due to unstable resting membrane potential which
triggers impulses in S.A node. Also called as prepotential .
– It is a potential with respect to depolarization & repolarization
phenomenon.
• Artificial Pacemaker:
– Speed up a slow heartbeat
– Help end an abnormal and fast
– Make sure the ventricles contract
– Coordinate the electrical signaling
between the ventricles
 Pacemaker contd…

• Significance:
– Temporary pacemakers are used to treat temporary heartbeat
problems, such as a slow heartbeat due to heart attack, heart
surgery, or an overdose of medicine. In this article,
"pacemakers" refers to permanent devices, unless stated
otherwise.
– Doctors also treat arrhythmias with another device called an
implantable cardioverter defibrillator (ICD).
 S.A NODE
• Location: Situated in the upper part of right atrium
• Importance: Primary Pacemaker is a specialized bundle of
neurons known as the sinoatrial node (SA node)
• Wat happens if SA node doesn’t function?
– If the SA node does not function, or the impulse generated in the
SA node is blocked before it travels down the electrical
conduction system, a group of cells further down the heart will
become the heart's pacemaker
– In S.A Node, the state of hyperpolarization decreases the RMP
to more negative(-65 to -75 mv) than normal( -55 to -60mv)
which slows down the rhythmicity of nodal fibers
 A.V. NODE
• It was kishne & Muscha from study of electrocardiograms,
expressed their view s that sinus impulse are not transmitted radially
but instead through specific pathways
• Location: AV node is an area of specialized tissue between the
atria and the ventricles of the heart, specifically in the posteroinferior
region of the interatrial septum.It is located at the center of Koch's
Triangle
• Importance: AV node is an area of specialized tissue between
the atria and the ventricles of the heart, specifically in the
posteroinferior region of the interatrial septum.It is located at the
center of Koch's Triangle
• In A.V node, state of hyperpolarization decreases the electrical
activity of nodal fibres for excitation.
 Internodal Atrial Pathways
• They conduct impulses from SAN to AVN by arranging
themselves in 2 bundles:
1.Anterior internodal tract of Bachmann. (can conduct impulses
from SAN to LA.
2.Middle internodal tract of Wenckeback.
3.Posterior internodal tract of thorel.
 Bundle Of His/ Atrioventricular Bundle
• Were named after the Swiss cardiologist Wilhelm
• Specialized for electrical conduction that transmits the
electrical impulses from the AV node to ventricles
• Significance:
– Special character of A-V bundle is the inability (xcept in
abnormal states) of action potential to travel backwards in
bundle from ventricles to atria
• If the Bundle of His is blocked, it will result in dissociation
between the activity of the atria and that of the ventricles,
otherwise called a third degree heart block
 Purkinjee System
• Jan Evangelista Purkinje
• They are larger and thicker than normal ventricular
muscle fibers
• Characteristic feature is that they have very few
myofibrils which means they barely contract during
impulse transmission
• Autorhythmicity:
– Thus they serve as the last resort when other pacemakers fail.
During the ventricular contraction portion of the cardiac cycle,
the 4.Purkinje fibers carry the contraction impulse from the left
and right bundle branches to the myocardium of the ventricles.
This causes the muscle tissue of the ventricles to contract and
force blood out of the heart
 ECG
• Each time the heart beats, it sends out an
electric-like signal. The heart's electrical
signals can be measured with a special
machine called an electrocardiogram (EKG
or ECG).

•Three major waves of electric signals appear on the ECG. . The first wave
is called the P wave. It records the electrical activity of the heart's two
upper chambers (atria).The second and largest wave, the QRS wave,
records the electrical activity of the heart's two lower chambers
(ventricles).The third wave is the T wave.
Cardiac Conduction System