Conduction

system of the
heart
Dr. Niranjan Murthy
HL
Asst Prof of
Physiology
SSMC, Tumkur
• Two types of muscle fibers-
contractile and conducting
• Contractile fibers in atria and
ventricles- form two functional
syncytia due to presence of gap
junctions
• Conducting system includes SA
Node, internodal tracts, AV Node,
Bundle of His, Bundle branches and
purkinje fibers
• Conducting system has-
• i) less cross-striations
• ii) less glycogen
 The Conduction System

• Conduction system
– Specialized electrical (pacemaker) cells in the
heart arranged in a system of pathways

• Normally, the pacemaker site with

the fastest firing rate controls the
heart
 Sinoatrial (SA) Node

• Initiates
electrical
impulses at a
rate of 60 to
100 beats/min
• Normally the
primary
pacemaker of
the heart
• Small, flattened, ellipsoid strip of
specialized muscle
• Size- 3 x 15 x 1mm
• Situation- superior lateral wall of
right atrium below and lateral to
opening of superior venacava
• Pacemaker of heart
• P cells- primitive cells- pale- rhythm
generators
 Atria

• Fibers of SA node connect directly with

fibers of atria

• Impulse leaves SA node and is spread from

cell to cell across the atrial muscle
 Internodal Pathways
• Conduction through the AV node
begins before atrial depolarization is
completed
• Impulse is spread to AV node via
internodal pathways
– Pathways merge gradually with cells of AV
node
• Connect SA Node
and AV Node
• Faster rate of
conduction than
Atrial muscles
• Anterior-
Bachman’s
bundle
• Middle-
Wenkebach’s
bundle
• Posterior-
 AV Junction
• Area of
specialized
conduction
tissue
– Provides
electrical links
between
atrium and
ventricle
 AV Node

• Located in the posterior septal wall of

the right atrium
– Supplied by right coronary artery in most individuals

• As the impulse from the atria enters

the AV node, there is a delay in
conduction of the impulse to the
ventricles
– Allows time for atria to empty contents into ventricles
 AV Node

• Divided into three

functional regions
according to their
action potentials and
responses to electrical
and chemical
stimulation
– Atrionodal (AN) or upper
junctional region
– Nodal (N) region
 AV Node
• The primary
delay in the
passage of the
electrical
impulse from
the atria to the
ventricles
occurs in the
AN and N
areas of the
• Only conducting pathway between
atria and ventricles normally

• Has thinner fibers with more

negative RMP & fewer gap junctions
causing conduction delay

• Velocity of conduction-
0.05m/sec

• It acts as pacemaker when SA Node

is damaged
 Bundle of His

• Also called the “common bundle” or

the “AV bundle”
• Normally the only electrical
connection between the atria and the
ventricles
– Connects AV node with bundle branches
– Has pacemaker cells capable of discharging at an
intrinsic rate of 40 to 60 beats/min
• It begins from AV Node, passes
downwards in the intraventricular
septum for 5-15mm

• Divides into right and left bundle

branches

• Left branch divides into anterior and

posterior fasciculus
 Right & Left Bundle
Branches
• Right bundle branch
– Innervates the right ventricle

• Left bundle branch

– Spreads the electrical impulse to the interventricular
septum and left ventricle
– Divides into three divisions (fascicles)
• Anterior fascicle
• Posterior fascicle
• Septal fascicle
 Purkinje Fibers
• Elaborate web of fibers that penetrate
about 1/3 of the way into the ventricular
muscle mass
– Become continuous with cardiac muscle fibers

• Receive impulse from bundle branches

and relay it to ventricular myocardium
• Fastest conducting
• 1-2 mm thick; largest conducting fiber
• Intrinsic pacemaker ability of 20 to 40
beats/min
 ORIGIN AND SPREAD OF
IMPULSES
SA Node

Anterior bundle Middle bundle Posterior bundle

of bachman of wenkebach Of thorel

AV Node

Bundle of His

Right & left

bundle branches

Purkinje fibers
 0.09 0.22

0.00

0.19
0.03 0.16 0.21
0.18
0
0.19.17
0.18

0.21
0.20
 CONDUCTION RATES
TISSUE m/sec

Atrial muscle 0.3

Internodal tract 1.0

AV Node 0.05

Purkinje fibers 1.5-4

Ventricle muscle 1.0

 AV Nodal delay
• Delay in transmission of impulses to
ventricles by 0.13sec-( 0.09 at AVN &
0.04 at AV bundle)
Causes of delay-
i) smaller size of fibers
ii) smaller number of gap junctions
iii) more negative RMP
Significance-
a) atria contracts 0.1sec earlier than
ventricle
b) limits the number impulses transmitted
to ventricles- <230/min
STOKES ADAMS SYNDROME
• Seen during acute, complete AV
block
• Ventricles stop beating
• Person faints due reduced blood
supply to brain
• Ventricle recovers after few seconds
& starts generating own impulses
• Rx- artificial pacemaker
 FACTORS AFFECTING
CONDUCTIVITY

• 1) Nervous stimulation
• 2) Hormones
• 3) Drugs
• 4) Ions
• 5) temperature