
The human heart is a pump made up of muscle tissue. Like all muscles, it requires a source of energy and oxygen to function. The heart's pumping action is regulated by an electrical conduction system that coordinates the contraction of its various chambers. This electrical system is critical to the functioning of the heart, controlling the electrical impulses that cause it to beat. These impulses can be detected and measured by an electrocardiogram (EKG).
| Characteristics | Values |
|---|---|
| Nature of the electrical impulse | The electrical impulse is generated by the sinus node (also called the sinoatrial node, or SA node) |
| Location of the sinus node | In the upper part of the heart's right atrium |
| Function of the sinus node | The sinus node is the heart's natural pacemaker and controls the heart rate |
| Heart rate | In a normal sinus rhythm, the rate is between 60 and 100 beats per minute |
| Heart block | The least severe degree of heart block is when electrical signals are slowed but still reach the ventricles; the most severe degree is when electrical signals completely fail to reach the ventricles |
| Detection of electrical impulses | An electrocardiogram (EKG) can be used to assess the rhythm of the heart and detect electrical impulses |
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What You'll Learn

The sinus node
The electrical impulse generated in the sinus node spreads across the right and left atria, causing them to contract. This process is known as atrial depolarization and pushes blood into the ventricles, the bottom two chambers of the heart. As the electrical impulse passes through the atria, it generates a "P" wave on an electrocardiogram (EKG) or electrocardiogram, which is used to assess the heart's electrical activity and detect any abnormalities.
Sinus node dysfunction (SND), also known as sick sinus syndrome, can occur when the sinus node is defective, leading to abnormal heart rhythms. This can manifest as pathological bradycardia (a slower than normal heart rate) and asystolic pauses, where the heart temporarily stops beating. SND can be caused by various factors, including age-related changes, inflammation of the heart tissue, certain medications, and abnormal blood electrolyte levels. Treatment for SND may include the implantation of an electronic pacemaker to regulate heart rhythm.
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Electrical impulses and heart rate
The heart is a pump made up of muscle tissue. Like all muscles, the heart requires oxygen and energy to function. The heart's pumping action is regulated by an electrical conduction system that coordinates the contraction of its various chambers. The heart's electrical conduction system is a network of nodes, cells, and signals that controls the heartbeat. Each heartbeat is caused by an electrical impulse generated by the sinus node, a tiny structure located in the upper portion of the right atrium. The right atrium is one of the four chambers of the heart, with two atria at the top and two ventricles at the bottom.
The electrical impulse generated by the sinus node spreads across the right and left atria, causing them to contract. This action, known as atrial depolarization, pushes blood into the ventricles. As the electrical impulse passes through the atria, it creates a "P" wave on an electrocardiogram (EKG), which is used to assess the heart's electrical activity and identify any irregularities.
The electrical impulse then reaches the atrioventricular (AV) node, located in the middle of the heart between the atria and ventricles. The AV node slows down the electrical impulse for a brief period before it continues through the bundle of His into the ventricles. The bundle of His divides into right and left bundle branches to stimulate the respective ventricles.
The electrical impulses control the heart rate by determining the number of heartbeats. In a normal sinus rhythm, the heart rate is between 60 and 100 beats per minute. The sinus node, also known as the heart's natural pacemaker, regulates the electrical conduction as it spreads across the heart. It ensures that the heart muscle cells contract in the correct sequence, resulting in regular, efficient, and coordinated heartbeats.
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The cardiac conduction system
The human heart is a pump made of muscle tissue. It requires a source of energy and oxygen to function. The heart's pumping action is regulated by an electrical conduction system that coordinates the contraction of its chambers. This electrical system controls the heartbeat and their conduction, which organises the beating of the heart.
The electrical impulse then reaches the AV disc, where it is stopped, except in the AV node. The AV node is a layer of fibrous tissue that keeps the electrical signal passing through it. The impulse travels through the AV node at a slow, controlled rate toward the ventricles, causing a pause in the electrical activity on the EKG, referred to as the PR interval. The AV node is crucial in ensuring the correct sequence of heart muscle cell contraction, resulting in regular, efficient, and coordinated heartbeats.
Finally, the electrical impulse continues down the conduction pathway via the bundle of His into the ventricles. The bundle of His divides into right and left bundle branches to stimulate the right and left ventricles. This results in the ventricles contracting and pumping out blood.
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Heart block
The heart, one of the most vital organs in the human body, is a muscular pump that operates through rhythmic contractions. These contractions are controlled and coordinated by electrical impulses, which are generated by specialised cells in the heart's conduction system. This system ensures that the heart beats in a coordinated manner, with the upper chambers (atria) contracting first, followed by the lower chambers (ventricles). The electrical impulses that govern this process originate in the sinoatrial (SA) node, commonly known as the heart's natural pacemaker.
However, in certain conditions, the electrical impulses are disrupted, resulting in a condition known as a 'heart block'. Heart block is characterised by a blockage or delay in the electrical signals travelling through the heart, hindering the normal rhythm of heart contractions. This disruption can occur at different levels of the heart's conduction system, leading to varying degrees of severity.
There are three types of heart block: first-degree, second-degree, and third-degree heart block. In a first-degree heart block, the electrical signals are merely delayed as they pass through the heart's conduction system, resulting in a slower heart rate. This type of block is usually mild and often does not require treatment.
Second-degree heart block is more severe and can be further categorised into two types: Type I and Type II. In Type I second-degree heart block, also known as Wenckebach block or Mobitz Type I, the delay in the electrical signals increases with each heartbeat until eventually, a signal fails to reach the ventricles, resulting in a dropped beat. This type of block usually does not require treatment unless it progresses into a more severe form. Type II second-degree heart block, or Mobitz Type II, is characterised by sudden, unexpected missed beats, indicating a more serious blockage. This type often requires the implantation of a pacemaker to regulate the heart rhythm.
The most severe form is the third-degree heart block, also known as complete heart block. In this condition, the electrical signals from the atria do not reach the ventricles, causing the two sets of chambers to beat independently of each other. This results in a very slow and irregular heartbeat, which can lead to serious complications such as dizziness, fainting, or even cardiac arrest. Individuals with this type of heart block typically require a pacemaker to normalise their heart rhythm and prevent further health issues.
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Detecting issues with the heart's electrical system
The heart's electrical system is critical to its function, controlling the electrical impulses that cause the heart to beat. The cardiac conduction system sends electrical signals that tell different parts of the heart to relax and contract, regulating blood flow through the heart and to the rest of the body.
Electrocardiogram (EKG/ECG)
A doctor may use an electrocardiogram to assess the rhythm of the heart. This test involves recording the electrical activity of the heart with several small stickers attached to the chest. The movement of electrical signals across the heart is what is traced on an EKG. The EKG is also what allows irregularities in the heart's electrical system, and with them any related symptoms and medical conditions, to be assessed. An EKG can detect bundle branch block, a type of conduction disorder.
Electrophysiology Study
An electrophysiology study can give even more information about your cardiac conduction system.
Medicine and Procedures
Medicine and procedures like a pacemaker placement can treat issues with your cardiac electrical system. Beta-blockers, for example, can inhibit the part of the nervous system that speeds up the heart, which can have the side effect of delaying electrical conduction within the heart, causing first-degree heart block. Calcium channel blockers can also slow down the conduction within the heart's AV node, resulting in first-degree heart block.
Healthy Habits
While you can't change the genetics that cause many problems with heart rhythm, you can help keep your heart well with healthy habits. This includes reaching and maintaining a healthy weight, stopping the use of tobacco products, and avoiding secondhand smoke.
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Frequently asked questions
Yes, the heart generates its own electrical impulses.
The electrical impulses control the heartbeat. Each impulse generates one heartbeat, and the number of impulses determines the heart rate.
The electrical impulses originate in the sinus node (also called the sinoatrial node or SA node), which is located in the upper right chamber (atrium) of the heart.
A doctor can use an electrocardiogram (ECG or EKG) to measure the electrical activity and rhythm of the heart.
Issues with the electrical impulses can cause an abnormal heart rhythm, which may result in a very rapid or slow heartbeat. Treatment options include medication or procedures such as pacemaker placement.






























