Heart electrical activity

It was thus possible to demonstrate that Hypericum extract, even at high doses, does not adversely influence depolarization in a patient sample with pre-existing pathological alterations of heart electrical activity. The drug therefore appears suitable for patients with cardiac risk factors. 

Wu, K., Zhang, Y., 2008. Contactless and continuous monitoring of heart electric activities through clothes on a sleeping hed. In International Conference on Information Technology and Applications in Biomedicine, Shenzhen, pp. 282—285. 

FIGURE 10.21 Simultaneous registration of (1) heart mechanical pumping activity, (2) heart electrical activity, and (3) lung mechanical ventilation, using only two electrodes. (From Patterson R. 1995. The Biomedical Engineering Handbook. Boca Raton, FL, CRC Press, 3rd edition, pp. 1223-1230.)... 

Heart Electrical Activity, Source on the Internet HeartSite.com,... 

Although death may be attributable to many tmderlying conditions, the final common pathway remains the cessation of the heart electrical activity. With hospitalized patients, cardiac arrest is usually manifested by ventrieular fibrillation, from which the patient may or may not be resuscitated. Sudden eardiae death, which claims over 350,000 lives annually in the United States, results from abrupt disruption of heart rhythm, also primarily in the form of ventricular fibrillation. Death in those instances is due not to extensive cardiac injury, but rather, to transient triggers that impinge on the electrically unstable heart (65-67). Identification of individuals at risk for sudden cardiac death remains a major objective in cardiology. Similarly, the specific mechanism linking ambient air particle exposure to death is unknown. 

One of the more intriguing cardiovascular developments is cardiomyoplasty where implantable technologies are blended with another part of the body to take over for a diseased heart. One company, Medtronic, in close collaboration with surgeons, has developed a cardiomyoplasty system to accompany a technique of wrapping back muscle around a diseased heart which can no longer adequately pump. A combination pacemaker and neurological device senses the electrical activity of the heart and correspondingly trains and stimulates the dorsal muscle to cause the defective heart to contract and pump blood. Over 50 implants have been performed to date. 

The amide local anaesthetic lidocaine may also be used as an antianhythmic for ventricular tachycardia and exra-systoles after injection into the blood circulation. Drugs with high lipid solubility such as bupivacaine cannot be used for these purposes because their prolonged binding to the channel may induce dysrhythmias or asystolic heart failure [3]. Systemically applied lidocaine has also been used successfully in some cases of neuropathic pain syndromes [4]. Here, electrical activity in the peripheral nervous system is reduced by used-dependent but incomplete sodium channel blockade. 

An arrhythmia may occur as a result of heart disease or from a disorder that affects cardiovascular function. Conditions such as emotional stress, hypoxia, and electrolyte imbalance also may trigger an arrhythmia An electrocardiogram (ECG) provides a record of the electrical activity of the heart. Careful interpretation of the ECG along with a thorough physical assessment is necessary to determine the cause and type of arrhythmia The goal of antiarrhythmic drug therapy is to restore normal cardiac function and to prevent life-threatening arrhythmias. 

The mechanical activity of the heart (contraction of the atria and ventricles) occurs as a result of the electrical activity of the heart. The heart possesses an intrinsic electrical conduction system (Fig. 6-1). Normal myocardial contraction cannot occur without proper and normal function of the heart s electrical conduction system. Electrical depolarization of the atria results in atrial contraction, and ventricular depolarization is... 

The electrocardiogram (ECG) is a non-invasive means of measuring the electrical activity of the heart. The relationship... 

Electrocardiogram A noninvasive method of recording the electrical activity of the heart. 

Signals are also transmitted to the reticular formation of the brainstem by way of the spinoreticular tract. The reticular formation plays an important role in the response to pain. First, it facilitates avoidance reflexes at all levels of the spinal cord and, second, it is responsible for the significant arousal effects of pain. Signals from the reticular formation cause an increase in the electrical activity of the cerebral cortex associated with increased alertness. Furthermore, it sends nerve impulses to the hypothalamus to influence its functions associated with sudden alertness, such as increased heart rate and... 

Figure 13.4 Electrocardiogram. The electrocardiogram (ECG) is a measure of the overall electrical activity of the heart. The P wave is caused by atrial depolarization, the QRS complex is caused by ventricular depolarization, and the T wave is caused by ventricular repolarization.

The ECG has several noteworthy characteristics. First, the firing of the SA node, which initiates the heart beat, precedes atrial depolarization and therefore should be apparent immediately prior to the P wave. However, due to its small size, it does not generate enough electrical activity to spread to the surface of the body and be detected by the electrodes. Therefore, there is no recording of the depolarization of the SA node. 

Intraventricular conduction delay often leads to late activation of the left ventricular free wall with significant mechanical consequences. The mechanical consequences of abnormal electrical activation of the heart have long been recognized [58, 60, 86]. These include dyssynchrony between the atria. 

Schematic representation of the heart and normal cardiac electrical activity (intracellular recordings from areas indicated and ECG). Sinoatrial (SA) node, atrioventricular (AV) node, and Purkinje cells display pacemaker activity (phase 4 depolarization). The ECG is the body surface manifestation of the depolarization and repolarization waves of the heart. The P wave is generated by atrial depolarization, the QRS by ventricular muscle depolarization, and the T wave by ventricular repolarization. Thus, the PR interval is a measure of conduction time from atrium to ventricle, and the QRS duration indicates the time required for all of the ventricular cells to be activated (ie, the intraventricular conduction time). The QT interval reflects the duration of the ventricular action potential.

By these mechanisms, antiarrhythmic drugs can suppress ectopic automaticity and abnormal conduction occurring in depolarized cells— rendering them electrically silent—while minimally affecting the electrical activity in normally polarized parts of the heart. However, as... 

Heart muscle fibers are coupled by gap junctions. These intercellular channels provide the exchange of small molecules (<1,000 D), like second messengers, between the cells and they allow electrical coupling. Thus, these cells connected to each other form a syncytium. However, from mapping studies it became evident that under certain conditions, e.g. regional ischemia, the ischemic region uncouples. In addition, mapping studies demonstrated that there is a special activation pattern which accounts for a directed activation of the whole heart. This activation pattern exhibits a considerable similarity from beat to beat. It is well known that the conduction velocity varies between... 

Furthermore, synchronization of contraction is facilitated by gap junctional communication as well as synchronization of electrical activation. The electrical coupling between cardiomyocytes mitigates differences in the membrane potential between these cells, for example in the course of an action potential if both cells repolarize at different timepoints. This results in smaller differences in the repolarization times thereby causing a reduction in the dispersion of the action potential duration. Since increased dispersion is known to make the heart more prone to reentrant arrhythmia, sufficient gap junctional communication can be considered as an endogenous arrhythmia-preventing mechanism. For a detailed discussion of the role of gap junctional communication in the biophysics of cardiac activation as related to anisotropy, nonuniformity and stochastic phenomena, see chapter 1 for a discussion of their role in arrhythmia, see chapter 6, and for a possible pharmacological intervention at the gap junctions for suppression of arrhythmia, refer to chapter 7. 

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