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Purkinje fibers also have the ability of firing at a rate of 20–40 beats per minute if upstream conduction or pacemaking ability is compromised. [9] In contrast, the SA node in normal state can fire at 60-100 beats per minute. [9] In short, they generate action potentials, but at a slower rate than the sinoatrial node. [9]
An impulse (action potential) that originates from the SA node at a relative rate of 60–100 bpm is known as a normal sinus rhythm. If SA nodal impulses occur at a rate less than 60 bpm, the heart rhythm is known as sinus bradycardia. If SA nodal impulses occur at a rate exceeding 100 bpm, the consequent rapid heart rate is sinus tachycardia ...
The Purkinje fibers have a fast inherent conduction rate, and the electrical impulse reaches all of the ventricular muscle cells in about 75 ms. Since the electrical stimulus begins at the apex, the contraction also begins at the apex and travels toward the base of the heart, similar to squeezing a tube of toothpaste from the bottom.
The blood supply of the AV node is from the atrioventricular nodal branch. The origin of this artery is most commonly (80–90% of hearts) a branch of the right coronary artery, with the remainder originating from the left circumflex artery. [4] [5] [6] This is associated with the dominance of the coronary artery circulation.
The left and right bundle branches, and the Purkinje fibers, will also produce a spontaneous action potential at a rate of 30–40 beats per minute, so if the SA and AV node both fail to function, these cells can become pacemakers. These cells will be initiating action potentials and contraction at a much lower rate than the primary or ...
Purkinje fibres: 20–40 bpm; The potentials will normally travel in order SA node → Atrioventricular node → Purkinje fibres Normally, all the foci will end up firing at the SA node rate, not their intrinsic rate in a phenomenon known as overdrive-suppression. Thus, in the normal, healthy heart, only the SA node intrinsic rate is observable.
The impulse then spreads through both ventricles via the bundle of His and the Purkinje fibers causing a synchronized contraction of the heart muscle and, thus, the pulse. [citation needed] In adults, the normal resting heart rate ranges from 60 to 90 beats per minute. The resting heart rate in children is much faster.
The first finding is that junctional rhythms are regular rhythms. This means that the time interval between beats stays constant. The next normal finding is a normal QRS. Since the impulse still travels down the bundle of His, the QRS will not be wide. Junctional rhythms can present with either bradycardia, a normal heart rate, or tachycardia. [9]