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Cardiac Cell Action Potential

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Decoding the Cardiac Cell Action Potential: A Step-by-Step Guide



The rhythmic beating of our heart, a marvel of biological engineering, is orchestrated by the precise electrical activity of cardiac cells. Understanding the cardiac cell action potential – the rapid fluctuation in membrane potential that underlies this rhythmic contraction – is crucial for comprehending normal heart function and diagnosing various cardiac pathologies. Arrhythmias, heart failure, and the effects of various drugs all hinge on alterations in this fundamental electrical process. This article aims to unravel the complexities of the cardiac action potential, addressing common challenges and providing a step-by-step understanding.

I. Phases of the Cardiac Action Potential: A Detailed Breakdown



The cardiac action potential differs significantly from the action potentials seen in neurons. Its longer duration and unique ionic currents are essential for coordinated heart contractions. We can break it down into five key phases:

Phase 0: Rapid Depolarization: This phase is characterized by a dramatic increase in membrane potential. It's primarily driven by the rapid influx of sodium ions (Na⁺) through voltage-gated fast sodium channels. These channels open upon reaching a threshold potential, causing a sudden and steep rise in membrane potential. Think of it as the “ignition” of the electrical signal.

Phase 1: Early Repolarization: Following the peak of depolarization, a brief repolarization occurs. This is due to the inactivation of fast sodium channels and the activation of transient outward potassium currents (Ito). It's a relatively short and less dramatic phase compared to phase 0.

Phase 2: Plateau Phase: This is a unique and defining feature of the cardiac action potential. The membrane potential remains relatively stable near its peak for an extended period. This plateau is maintained by a balance between inward calcium (Ca²⁺) current through L-type calcium channels and outward potassium (K⁺) current through delayed rectifier potassium channels. This prolonged depolarization is crucial for the sustained contraction of the heart muscle.

Phase 3: Rapid Repolarization: The plateau phase ends as the calcium current decreases and the potassium current increases. This leads to a rapid repolarization back towards the resting membrane potential. The delayed rectifier potassium channels play a major role in this phase.

Phase 4: Resting Membrane Potential: The membrane potential returns to its resting state, typically around -90 mV. This phase is maintained by the activity of various potassium channels that leak potassium ions out of the cell, counterbalanced by the sodium-potassium pump which actively transports sodium ions out and potassium ions into the cell, maintaining the electrochemical gradient.


II. Ionic Currents and their Importance



Understanding the specific ionic currents driving each phase is vital. Malfunctions in any of these currents can lead to arrhythmias. For instance:

Reduced sodium current (Phase 0): Could lead to slowed conduction velocity, potentially causing heart block.
Increased calcium current (Phase 2): Could prolong the action potential duration, increasing the risk of arrhythmias.
Reduced potassium current (Phase 3): Could prolong the action potential duration, also increasing the risk of arrhythmias.

Understanding these relationships allows clinicians to interpret ECG changes and predict the effects of various drugs. For example, class I antiarrhythmic drugs affect sodium channels, while class III drugs affect potassium channels.


III. Differences in Cardiac Cell Action Potentials



It’s crucial to remember that cardiac action potentials aren't uniform across the heart. Different cell types exhibit variations:

Pacemaker cells (SA and AV nodes): These cells have a spontaneously depolarizing Phase 4, initiating the heartbeat. They lack a true resting potential.
Atrial and Ventricular myocytes: These cells have the characteristic five-phase action potential described above, but with variations in action potential duration and the relative contributions of different ionic currents.
Purkinje fibers: These specialized conducting cells have a rapid conduction velocity due to high sodium current density and a shorter action potential duration compared to ventricular myocytes.


IV. Troubleshooting Common Challenges



Many challenges arise when studying cardiac action potentials. For instance:

Interpreting ECGs: ECGs represent the sum of electrical activity across the heart. Understanding how individual cell action potentials contribute to the overall ECG waveform requires practice and understanding of cardiac conduction pathways.
Modeling cardiac action potentials: Computational models are frequently used to simulate cardiac electrophysiology. However, these models require careful parameterization and validation.
Understanding the effects of drugs and disease: Many factors influence action potentials. Understanding how drugs and diseases affect specific ionic currents is crucial for diagnosis and treatment.


V. Summary



The cardiac action potential is a complex yet elegantly designed process underpinning the heart's rhythmic contractions. Its five phases are defined by the interplay of various ionic currents. Understanding these phases, the specific ionic channels involved, and the variations across different cardiac cell types is essential for comprehending normal heart function and diagnosing a wide range of cardiac disorders. The ability to interpret ECGs and utilize computational models further enhances our capacity to analyze and manage cardiac electrophysiological events.


FAQs



1. What is the role of the sodium-potassium pump in the cardiac action potential? The sodium-potassium pump actively transports sodium ions out of the cell and potassium ions into the cell, maintaining the electrochemical gradient and contributing to the resting membrane potential (Phase 4).

2. How do calcium channel blockers affect the cardiac action potential? Calcium channel blockers reduce the inward calcium current during Phase 2, shortening the action potential duration and decreasing heart rate.

3. What is the significance of the plateau phase? The plateau phase ensures a sustained contraction of the cardiac muscle, allowing sufficient time for blood ejection from the heart.

4. How does the action potential propagate through the heart? The action potential propagates through gap junctions connecting cardiac cells, allowing for synchronized contraction.

5. What are some common diseases that affect the cardiac action potential? Long QT syndrome, Brugada syndrome, and various channelopathies are examples of diseases that disrupt the normal cardiac action potential, leading to arrhythmias.

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Cardiac electrophysiology: Action potential, automaticity and vectors The action potential occurs in all cardiac cells but its appearance varies depending on cell type. During de- and repolarization ions (Na + [sodium], K + [potassium] and Ca 2+ [calcium]) flow back and forth across the cell membrane.

Cardiac Action Potential - an overview | ScienceDirect Topics The cardiac action potential is a measurement of the membrane potential waveform of the cardiac myocytes signifying the electrical activity of the cell during the contraction and relaxation of the heart.

Cardiac Action Potentials - CV Pharmacology Antiarrhythmic drugs that block or facilitate the movement of these ions are used to alter cardiac action potentials to prevent or stop arrhythmias. In non-nodal tissue, sodium-channel blockers decrease the fast inward movement of Na +, which decreases the slope of phase 0 and the magnitude of depolarization.

047 Action Potentials and Contraction in Cardiac Muscle Cells We have a stimulus that comes from the AV node or the SA node and that spreads to the muscle cells. In response to that, what’s going to happen is that the membrane potential of the cardiac muscle cells is all of a sudden going to depolarize very quickly. So, …

Action Potentials Made Easy: Cardiac Myocyte (Heart Muscle Cell… 3 Jun 2020 · This post will focus on the action potentials of cardiac pacemaker cells and cardiac muscle cells (non-pacemaker cells). Understanding cardiac action potentials becomes clinically relevant when using antiarrhythmic drugs or managing conduction disorders.

Cardiac Action Potentials – Human Physiology - University of … At this point, we have seen three action potential diagrams: neurons, nodal cells, and cardiac myocytes. How do these three action potential profiles differ in shape, refractory periods, and types of ion channels involved?

Cardiac Action Potential - Radboudumc • Cardiac autorhythmic cells in the intrinsic conduction system generate action potentials that spread in waves to all the cardiac contractile cells. This action causes a coordinated heart contraction. Of all the cells in the body, only heart cells are able to contract on their own without stimulation from the nervous system. Page 4. Gap Junctions.

Extracellular matrix cues regulate cardiac pacemaker cell … Extracellular matrix cues regulate cardiac pacemaker cell induction from ventricular myocytes Am J Physiol Heart Circ Physiol . 2025 Apr 10. doi: 10.1152/ajpheart.00217.2025.

Action potential of the heart | TEZECG The action potential of the heart muscle cells (myocytes) is divided into five main phases, labeled 0-4. These phases reflect the flow of ions in and out of the heart muscle cells, generating and propagating the electrical signal that leads to contraction.

Cardiac Action Potentials - The Student Physiologist Cardiac action potentials differ from the APs found in other areas of the body. Typical neural AP duration is around 1ms and those of skeletal muscle are roughly 2-5ms, whereas cardiac action potentials range from 200-400ms.

Physiology Philes: Cardiac Action Potential • LITFL • BSCC 3 Nov 2020 · We review how a generic action potential is generated, how a small electrical impulse stimulates the opening of fast and numerous sodium channels, allowing a swamping of the exterior of the cell membrane with positively charged ions, and a depolarisation.

Ventricular Action Potentials - Cardiac Cycle - TeachMePhysiology 1 Oct 2023 · In this article, we will look at how action potentials spread in ventricular cells, their shape and modulation in disease states. In order to understand ventricular action potentials, it is important to understand the basics how an action potential forms.

Cardiac Action Potential - an overview | ScienceDirect Topics The cardiac action potential (AP) is a brief change in voltage (membrane potential) across the cell membrane or sarcolemma. This is caused by the movement of charged cations between the inside and outside of the cell, through protein structures called ion channels.

Human induced pluripotent stem cell-derived cardiomyocytes and … 7 Apr 2025 · To promote the broad adoption of hiPS cell-derived cardiac OoCs in the drug development field, there is a need to first ensure reproducibility in their preparation and use. ... action potential 21 ...

Action Potentials - CV Physiology There are three general types of cardiac action potentials that are distinguished, in part, by the presence or absence of spontaneous pacemaker activity and by how rapidly they depolarize.

Cardiac electrophysiology: Action potential, automaticity and vectors 2 Jan 2017 · The action potential includes a depolarization (activation) followed by a repolarization (recovery). The action potential occurs in all cardiac cells but its appearance varies depending on cell type. During de- and repolarization ions (Na+ [sodium], K+ [potassium] and Ca2+ [calcium]) flow back and forth across the cell membrane.

Cardiac Action Potentials: Videos & Practice Problems - Pearson Action potentials are something that you've learned about before when you talked about skeletal muscle and when you talked about neurons. Well, the action potentials in cardiac muscle are going to be kind of similar, but there are some very key …

Cardiac transmembrane ion channels and action potentials: … 2. CARDIAC ACTION POTENTIAL. The cardiac action potential is a transmembrane potential change, with an amplitude ranging between 60 and 120 mV. It starts from a negative value, i.e., the resting membrane potential (RMP) in working myocardial cells or maximal diastolic potential in spontaneously beating cells , ranging from −95 to −40 mV.

Cardiac Action Potential - RK.MD 25 Jan 2021 · How do these action potentials differ from cardiac pacemaker action potentials? At what point do HCN channels become active in the pacemaker cells and do they work in conjunction with the Na/K ATPase, or do they replace their function?

Phases Of The Cardiac Action Potential - Sciencing 19 Oct 2018 · The cardiac cell action potential, like action potentials in nerves, is divided into five phases, numbered 0 through 4. Two of these, phase 2 (the plateau phase) and phase 4 (the diastolic interval) are marked by little to no change in voltage. Sodium, potassium and calcium are the primary ions.

Cardiac Ion Channels | Circulation: Arrhythmia and … 1 Apr 2009 · Figure 1 illustrates the 5 phases of the normal action potential: 1. Phase 4, or the resting potential, is stable at ≈−90 mV in normal working myocardial cells. 2. Phase 0 is the phase of rapid depolarization. The membrane potential shifts into positive voltage range.

Cardiac action potential - Wikipedia Unlike the action potential in skeletal muscle cells, the cardiac action potential is not initiated by nervous activity. Instead, it arises from a group of specialized cells known as pacemaker cells, that have automatic action potential generation capability.

An NRF2/β3-Adrenoreceptor Axis Drives a Sustained Antioxidant … 12 Mar 2025 · We and others have identified a protective action of cardiac β3-adrenergic receptors (β3ARs) against adverse cardiac remodeling. 9–11 This β3AR isotype has traditionally been considered a “metabolic” receptor because of its well-characterized lipolytic and “beiging” effect in the adipose tissue. 12–14 In the heart, β3AR expression, detected in human atrial and …