
The human heart is a hollow muscle that pumps blood to the lungs and the rest of the body. This pumping action is made possible by electrical impulses that trigger heartbeats. These impulses originate in a group of cells called pacemaker cells, located in the sinoatrial (SA) node or sinus node in the right atrium. The SA node generates an electrical stimulus regularly, 60 to 100 times per minute under normal conditions. This electrical signal then spreads through the chambers of the heart, causing the heart to contract and pump blood. The electrical impulses in the heart can vary in speed, resulting in conditions like bradycardia (slow heart rate) or tachycardia (fast heart rate).
| Characteristics | Values |
|---|---|
| Location of electrical impulse origin | Sinoatrial node (SA node) or sinus node |
| Location of SA node | Right atrium or upper chamber of the heart |
| Rate of electrical impulse generation | 60 to 100 times per minute under normal conditions |
| Heart rate at rest | 60 to 100 beats per minute is considered normal |
| Heart rate during exercise | Faster than at rest |
| Path of electrical impulse | SA node to atrioventricular node (AV node) to bundle of His and into ventricles |
| Function of AV node | Slows down the electrical impulse for a fraction of a second to allow atria to contract before ventricles |
| Outcome of abnormal impulse generation or transmission | Arrhythmia, tachycardia, or bradycardia |
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The sinus node
After stimulating the atria, the electrical impulse from the sinus node travels to the atrioventricular node (AV node), located in the middle of the heart between the atria and ventricles. At the AV node, the impulse is briefly slowed down before continuing down the conduction pathway through the bundle of His into the ventricles. The bundle of His divides into right and left pathways (bundle branches) to stimulate the right and left ventricles, causing them to contract and pump blood out of the heart.
The entire heartbeat process then starts again, beginning with an impulse in the sinus node. The sinus node's role as the heart's primary pacemaker is crucial for maintaining a regular heart rhythm. In some abnormal cases, other heart tissue may act as a secondary pacemaker, causing the heart to beat faster or slower than the normal rate set by the sinus node.
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Electrical signals
The heart is a hollow muscle that pumps blood to the lungs and the rest of the body. This pumping action is facilitated by electrical impulses that trigger heartbeats. The electrical signal begins in a group of cells called the pacemaker cells, located in the sinoatrial node (SA node) in the right atrium, which is the upper chamber of the heart. The SA node is a small area of specialized cells that generate an electrical stimulus regularly, 60 to 100 times per minute under normal conditions. This rate depends on a person's age; in general, a person's heart rate slows as they age.
The electrical signal then travels through the atria, causing them to contract and pump blood into the ventricles, which are the lower chambers of the heart. The atria contract a fraction of a second before the ventricles, allowing the blood from the atria to empty into the ventricles before the ventricles contract. The electrical signal then reaches the atrioventricular node (AV node), located between the atria and ventricles. At the AV node, the electrical signal slows down for a very short period, allowing the ventricles time to finish filling with blood before they contract.
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 pathways called bundle branches. These bundle branches provide electrical stimulation to the right and left ventricles, causing them to contract and pump blood out of the heart. The ventricles then relax, and the heartbeat process starts all over again in the SA node.
The cardiac conduction system is the special electrical system of the heart that controls the rate and rhythm of the heartbeat. Problems with the electrical impulses in the heart can cause it to beat too fast (tachycardia) or too slow (bradycardia). An irregular heart rhythm is called arrhythmia, and one of the most common types is atrial fibrillation. Conduction disorders can occur when electrical signals do not generate properly, do not travel properly through the heart, or both.
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Heartbeat process
The heartbeat process begins with an electrical impulse in the sinus node, also known as the sinoatrial node or SA node. This is a small mass of specialised tissue or a group of pacemaker cells located in the right upper chamber (atrium) of the heart. The sinus node generates an electrical stimulus regularly, approximately 60 to 100 times per minute under normal resting conditions. This rate can vary depending on a person's age, with a tendency for the heart rate to slow as one gets older. Exercise also influences heart rate, causing it to increase in order to deliver more oxygen to the body's muscles.
The electrical impulse then travels through the heart, causing it to contract. First, the 2 upper chambers of the heart (atria) are stimulated and contract for a brief period, pumping blood into the 2 lower chambers (ventricles). Next, the electrical signal reaches the atrioventricular (AV) node, located between the atria and ventricles. Here, the signal is delayed for a fraction of a second, allowing the atria to empty their blood into the ventricles before the ventricles contract.
After passing through the AV node, the electrical impulse continues down the conduction pathway, through a pathway known as the bundle of His, which divides into right and left bundle branches to stimulate the right and left ventricles. The ventricles then contract, sending blood throughout the body and completing one heartbeat. The entire process then starts again, beginning with an impulse in the sinus node.
The cardiac conduction system, the heart's special electrical system, controls the rate and rhythm of the heartbeat. However, certain conditions can affect this system, causing abnormalities in the heart's rhythm, a condition known as arrhythmia. Arrhythmia can manifest as a feeling of fluttering in the heart, shortness of breath, dizziness, or fainting. In children, an abnormally fast heartbeat, known as tachycardia, may be due to an extra electrical path that creates a continuous loop for the electrical impulse, resulting in a rapid heart rate. On the other hand, a slow heartbeat, or bradycardia, can be caused by heart block, which prevents the electrical signal from reaching the lower chambers of the heart.
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Bradycardia
The heart's electrical system is responsible for triggering heartbeats. The sinus node, a small mass of specialised tissue located in the right upper chamber (atria) of the heart, generates an electrical stimulus. This stimulus travels down through the conduction pathways, causing the heart's ventricles to contract and pump out blood.
The symptoms of bradycardia can vary, sometimes even being asymptomatic. In other cases, individuals with bradycardia may experience symptoms such as dizziness, shortness of breath, or fainting. Treatment options depend on the severity and underlying causes. Medication adjustments may be made if drugs are contributing to bradycardia. Additionally, pacemakers can be used to regulate the heart's rhythm and increase the heart rate when necessary.
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Conduction pathway
The heart's electrical conduction system is a collection of nodes and specialised conduction cells that initiate and coordinate the contraction of the heart muscle. The conduction pathway of the electrical impulse through the heart is as follows:
The electrical impulse begins in the sinoatrial (SA) node, a collection of specialised cells (pacemaker cells) located in the upper wall of the right atrium. These pacemaker cells can spontaneously generate electrical impulses, creating a wave of excitation that spreads via gap junctions across both atria, resulting in atrial contraction. The rate at which the SA node generates impulses is influenced by the autonomic nervous system. The sympathetic nervous system increases the firing rate of the SA node, leading to an increased heart rate, while the parasympathetic nervous system has the opposite effect, decreasing the heart rate.
After the electrical impulses spread across the atria, they converge at the atrioventricular (AV) node, located within the atrioventricular septum near the opening of the coronary sinus. The AV node is in the middle of the heart, between the atria and ventricles. The signal is delayed in the AV node, allowing the atria to contract a fraction of a second before the ventricles so that blood can empty into the ventricles before they contract.
From the AV node, the electrical impulse continues down the conduction pathway through the bundle of His, which is located in the interventricular septum. The bundle of His then divides into right and left bundle branches to stimulate the right and left ventricles. The bundle branches and Purkinje fibres spread the wave impulses along the ventricles, causing them to contract.
This sequence of electrical events during one full contraction of the heart muscle creates an electrical current that can be visualised on an electrocardiogram (EKG or ECG). Doctors use an EKG to assess the rhythm of the heart and evaluate the functioning of the cardiac conduction system.
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Frequently asked questions
The electrical impulses of the heart begin in a group of cells called pacemaker cells, located in the sinoatrial (SA) node or sinus node in the right atrium or upper chamber of the heart.
The SA node is a small mass of specialized tissue that generates electrical stimuli or signals regularly, 60 to 100 times per minute under normal conditions.
The SA node acts as the heart's pacemaker, creating an electrical signal that travels from the top to the bottom of the heart with each heartbeat.
After the SA node generates an electrical signal, the signal travels through the atria, causing them to pump blood into the ventricles.
Tachycardia is when the heart beats too fast, while bradycardia is when the heart beats too slowly. Both conditions can be caused by problems with the electrical impulses in the heart.































