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Gepubliceerd in:
Multivariable Evaluation of Candidates for Cardiovascular Disease hoofdstuk lezen eerste hoofdstuk lezen

2013 | OriginalPaper | Hoofdstuk

15. Electrophysiology of Cardiac Arrhythmias

Auteurs : Sei Iwai, MD, Steven M. Markowitz, MD, Bruce B. Lerman, MD

Gepubliceerd in: Essential Cardiology

Uitgeverij: Springer New York

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Abstract

Abnormalities in the initiation and propagation of cardiac impulses result in a variety of arrhythmias. The cardiac action potential consists of five phases that are determined by channels that allow ions to flow passively down their electrochemical gradients, as well as by a series of energy-dependent ion pumps, thereby leading to cardiac contraction.
Sodium, potassium, calcium, and chloride ions are principally responsible for the membrane potential (phase 4). Phase 0 marks the initiation of the action potential. In nodal cells, the pacemaker current, If, initiates each cycle. In “nonpacemaker” tissue, If is absent. In these cells, phase 0 is triggered when the cell membrane is depolarized by adjacent cells. Phase 1 consists of rapid membrane repolarization. This is achieved by inactivation of the inward Na+ current and activation of a transient outward current, Ito. Phase 2, the plateau phase, is characterized by a small change in membrane potential generated by the L-type calcium channel, ICa–L. Rapid repolarization of the cell occurs during phase 3. ICa–L is inactivated in a time-dependent fashion, thus decreasing the flow of cations into the cell, while several outward potassium currents become active. This results in a net outward positive current and a negative transmembrane potential.
The mechanisms of cardiac arrhythmias can be divided into three categories: (1) abnormal or enhanced automaticity, (2) triggered activity, and (3) reentry. This chapter reviews each of these mechanisms, along with the common clinical correlates of each.
vorige hoofdstuk Choosing Appropriate Imaging Techniques
volgende hoofdstuk Treatment of Cardiac Arrhythmias
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Metagegevens
Titel
Electrophysiology of Cardiac Arrhythmias
Auteurs
Sei Iwai, MD
Steven M. Markowitz, MD
Bruce B. Lerman, MD
Copyright
2013
Uitgeverij
Springer New York
Boek
Essential Cardiology

Print ISBN: 978-1-4614-6704-5

Elektronisch ISBN: 978-1-4614-6705-2

Copyright: 2013

DOI
https://doi.org/10.1007/978-1-4614-6705-2_15