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BIOM 3090 Final: Antiarrhythmias

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Biomedical Sciences
BIOM 3090
Bettina Kalisch

Anti-arrhythmias Normal cardiac rhythm  Electrical activity: SA node  spread through atria  AV node  purkinje fibers  Membrane potential maintained by distribution of ions on either side of cell membrane  At rest: Na is low, maintained by Na /K ATPase  Depolarization: Na influx through rapidly opening sodium channels 2+  Plateau: Ca influx through slowly opening calcium channels  Repolarization: closure of calcium channels, K efflux through channels  Restored by Na /K ATPase  Cardiac myocytes contract by excitation-contraction coupling  AP   Ca (ion channels and sarcoplasmic reticulum) 2+  Ca bind troponin and uncovers myosin binding site on actin  Actin and myosin cross-link  contraction  Relaxation: Ca released from troponin  back into SR and out of cell, actin and myosin release Arrhythmias  Problem with electrical control of heart rhythm  myocytes can’t contract in synch  compromised effective pumping  Altered initiation: SA node  can’t form impulse correctly  altered rate  Abnormal conduction: conduction block (bradyarrhythmia, in-excitable area of cells), reentry conduction (tachyarrhythmia, one area stimulated repeatedly and rapidly) Atrial arrhythmias  Normal HR: 60-80bpm  Atrial flutters: 200-350bpm  Atrial fibrillation: 300-500bpm, irregular and disorganized  Atrial arrhythmias do not alwa
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