
The human heart is a pump made up of muscle tissue. The heart's pumping action is regulated by an electrical conduction system that coordinates the contraction of the various chambers of the heart. The electrical signals that control the heartbeat are generated in a special part of the heart muscle called the sinus node or sinoatrial node (SA node). This node is a small mass of specialized tissue located in the right upper chamber (atria) of the heart. The SA node generates an electrical stimulus regularly, 60 to 100 times per minute under normal conditions.
| Characteristics | Values |
|---|---|
| Place of origin of electrical pulses in the human heart | Sinus node (also called the sinoatrial node or SA node) |
| Location of the sinus node | Right upper chamber of the heart (right atrium or atria) |
| Frequency of electrical pulses in the sinus node in adults | 60 to 100 times per minute |
| Frequency of electrical pulses in the sinus node in children | Not specified, but generally the heart rate slows with age |
| Direction of the electrical impulse | From the sinus node to the atrioventricular node (AV node) and then to the ventricles |
| Function of the electrical impulses | Causes the heart's lower chambers (ventricles) to contract and pump out blood |
| Effect of slowed electrical impulses | Decrease in heart rate, known as bradycardia |
| Effect of abnormally fast electrical impulses | Increase in heart rate, known as tachycardia |
| Medical test to assess the rhythm of the heart | Electrocardiogram (EKG) or ECG |
| Medical treatment for issues with the cardiac electrical system | Medicines or procedures like pacemaker placement |
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The sinus node
The SA node is composed of specialised cells known as pacemaker cells. These cells have a unique property called the pacemaker potential, which allows them to automatically generate electrical impulses. Once the pacemaker potential reaches a certain threshold, it triggers an action potential, initiating the heartbeat.
Sinus node dysfunction (SND), also known as sick sinus syndrome, can occur when the SA node malfunctions. This can lead to irregular heart rhythms, such as a slow heart rate (bradycardia), pauses in the heartbeat (sinus pauses or sinus arrest), or, in rare cases, a faster-than-normal heart rate. SND can be caused by various factors, including age-related changes, genetic mutations, and coronary artery disease. It is commonly diagnosed using electrocardiographic features, and treatment options may include implantable electronic pacemakers.
In summary, the sinus node, or SA node, is the heart's natural pacemaker, responsible for generating electrical impulses that initiate each heartbeat. Its proper function is crucial for maintaining a steady and regular heartbeat, and dysfunction of the sinus node can lead to potentially serious cardiac issues.
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The conduction pathway
The electrical pulses that coordinate the heartbeat originate in a small mass of specialised tissue called the sinus node, or sinoatrial node (SA node). The sinus node is located in the right upper chamber (right atrium) of the heart. From here, the electrical impulse travels through the conduction pathways, stimulating the heart's chambers to contract and pump blood.
The signal then reaches the atrioventricular node (AV node), located between the atria and ventricles. Here, the impulses are briefly slowed down, allowing the atria to contract first and empty their blood into the ventricles. After passing through the AV node, the electrical current continues down the conduction pathway through the bundle of His, which divides into right and left bundle branches.
These bundle branches provide electrical stimulation to the right and left ventricles, causing them to contract and pump blood out into the blood vessels of the body. The entire process, from the initial impulse in the sinus node to the contraction of the ventricles, constitutes one heartbeat. The heart contracts about 60 to 100 times per minute at rest, depending on age, with the heart rate generally slowing as a person gets older.
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The bundle of His
The AV node is located between the atria and ventricles, allowing the atria to contract a fraction of a second before the ventricles. After passing through the AV node, the electrical impulse travels through the bundle of His, which branches into the left and right bundle branches. These bundle branches then lead to the Purkinje fibres, which provide electrical conduction to the ventricles, causing their contraction.
Disorders affecting the bundle of His can lead to heart blocks, which impair the heart's ability to coordinate the activities of the atria and ventricles. This results in a decrease in the efficiency of pumping blood. One such disorder is a bifascicular block, where both the right bundle branch and either the left anterior or posterior fascicle are blocked. A standard bundle of His ECG can be performed to study the electrical conduction system and identify any malfunctions.
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The AV node
The atrioventricular (AV) node is a small structure in the heart, located in the Koch triangle, near the coronary sinus on the interatrial septum. It is an important component of the cardiac conduction system and is responsible for transmitting impulses that originate in the sinoatrial (SA) node to the ventricles of the heart. The AV node is made up of specialised cardiac muscle cells, also known as nodal cardiac muscle cells or nodal cells, which are bundled together to form a node within the wall of the interatrial septum. These nodal cells are smaller than typical cardiomyocytes and lack intercalated discs.
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The ventricles
Ventricles in the Heart
The electrical impulse travels from the sinus node to the AV node (atrioventricular node), where it is slowed down momentarily. This delay allows the atria to contract a fraction of a second before the ventricles, ensuring that blood from the atria empties into the ventricles before they contract. After passing through the AV node, the electrical current continues down the conduction pathway, through the bundle of His, and into the ventricles. The bundle of His splits into right and left pathways (bundle branches) to provide electrical stimulation to the right and left ventricles.
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Any obstruction in the flow of CSF within the ventricular system can lead to an abnormal accumulation of fluid, a condition known as hydrocephalus.
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Frequently asked questions
The electrical conduction system is the network of nodes, cells and signals that controls your heartbeat.
The sinus node, also called the sinoatrial node (SA node), is a small mass of specialised tissue in the right upper chamber of the heart (right atrium). It generates an electrical stimulus regularly, 60 to 100 times per minute under normal conditions.
The cardiac conduction system is the network of nodes, cells and signals that controls your heartbeat. It sends signals that tell different parts of your heart to relax and contract.




































