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Macris School


The Pacemaker:
A lifesaver using electricity.

Jose Rene Berlioz

Tuesday March 4, 2014

Your Hearts Electrical System
Beating an average of 100,000 times per day and about 35 million times in a year, the
human heart pumps a relentless amount of blood into our arteries throughout our lives. For this
major feat, the heart has a carefully designed electrical system. With four heart chamberstwo
lower chambers called ventricles and two upper chambers called atriathe heart has to contract
and relax each of them synchronously or a bad supply of blood would ensue. The hearts
electrical system is also called the cardiac conduction system
It all starts in cluster of cells called the Sinoatrial node. They are located in the right
atrium of your heart. Whenever your hearts right is filled with blood, the sinoatrial node sends a
signal that makes the atria cells to contract, or squeeze. This contraction pumps blood through
the tricuspid and mitral valves. The P-wave in your EKG (electrocardiogram) indicates this
activity. (Anonymous, 2011)
The electrical signal then arrives at the atrioventricular (AV) node near the ventricles.
The AV node serves by slowing down the signal, letting the ventricles fill with blood before
contracting (signal between the P and Q wave). Whereas the sinoatrial node controls the rhythm
of your pulse, the AV node sets the rhythm of your hearts contractions. If the atrium and
ventricle did not have this small delay (a tenth of a second) in the electrical signal transmission,
the ventricles wouldnt be able to fill themselves causing low blood pressure among other
problems. (Thompson, 2010)
After the delay, the AV node releases the signal which travels through a pathway called
the Bundle of His which is located in the ventricles walls (Q wave signal). Then, the signal
proceeds to leave the Bundle of His by the Purkinje fibers that connect directly to the walls of
your hearts ventricles. The ventricles contract at different times; the left ventricle contracts a
moment before the right ventricle. The R-wave in the EKG, the biggest wave, marks the
contraction of the left ventricle and the S-wave, marks the contraction of your right ventricle.
After the blood is pumped into your arteries and lungs, the ventricles start to relax marking the
last wave shown in the EKG, the T-wave. This process of contraction and relaxation repeats
again and again for the rest of your life.

The Pacemaker and the Heart Action Potential
Nevertheless, every system as perfect as it may seem, can fail. In this case, if our heart
electrical system fails our hearts delivery system fails as well; this in return creates complications
that must be fixed with the use of an artificial pacemaker.
The pacemaker is a tiny device that is placed in the chest or abdomen to regulate
abnormal heart rhythms. It consists of a powerful battery, an electronic circuit and a computer
memory that together can generate an electrical impulse. The signals are carried through
insulated wires to the heart muscles. (Heart Rhythm Society) .
The pacemaker replaces the activity of the natural pacemaker, the SA node. The SA node
works by creating the electrical impulse that induces the action potential on the heart cells. The
action potential is initiated by the ion-channels that are in each cell. The ions that transport from
the cell can be Na+, Ca2+, Cl-, and K+.
The action potential is the process in which the neural membrane opens to allow
positively charged ions into the cell and negatively charged ions outside the cell. The contractile
muscular fibers of the heart have a resting potential of 90 mV. Excitation of the fibers next to
them results in the opening of the voltage-gated Na+ channels and a quick depolarization occurs
as Na+ moves into the cell. Next the K+ voltage-gated channel also opens and moves out of the
cell creating equilibrium. The equilibrium last for approximately 25 milliseconds. Next, the K+
concentration moves out of equilibrium and repolarization of the heart occurs again. (Cherry)
When one part of the electrical system of the heart fails, interrupting the normal rhythm
of the heart, the pacemaker kicks in as a capacitor releasing its 90mV to initiate the action
potential of the heart cells and return them back to a normal rhythm by continuing to activate the
proper action potential until the heart can recover.

Reasons for Pacemakers
Your doctor may recommend pacemakers for many different reasons.
For instance, your sinus nodes ability to set the correct pace may be weakened by age or
heart disease. Other reasons include if you are taking certain kind of medicines like beta
blockers, youve had a medical procedure for atrial fibrillation, you have faints due to slow
heartbeat, or you are under cardiac resynchronization therapy. (Anonymous, 2012)

Types of Pacemakers
There are three basic types of pacemakers that exist for a varied of purposes. Single-
Chamber Pacemakers have only one wire placed into one of the chambers of the heart and they
are used for cases like arrhythmia and sinus node dysfunction. Double-Chamber Pacemakers are
placed in both the ventricle and the atrium of the heart. This latter approach helps by completely
pacing both the upper and lower chambers of the heart at desired rates. Finally, rate-responsive
pacemakers have sensors that automatically adjust to human body changes. (Heart Rhythm
Society) Newer pacemakers can even monitor blood temperature, breathing rate, heart rhythm
and heart electrical activity among many other factors.
Anonymous. Your Heart's Electrical System." National Heart, Lung and Blood Institute.
N.p., 11 Nov. 2011. Web. 03 Mar. 2014. <
Anonymous. How Does a Pacemaker Work? National Heart, Lung and Blood Institute.
Feb. 28, 2012. Web. 03 Mar. 2014 <
Thompson, E. Gregory, MD Internal Medicine. How does my Hearts Electrical System
Work. WebMD. March 18, 2010. Web. 03 Mar. 2014.
Heart Rhythm Society. Treatment and Devices. Web. 03 Mar. 2014.
Ashesh. Physics Fundamentals and Pacemakers. The Physics of a Pacemaker. Web. 03
Mar. 2014.
Cherry, Kendra. What is an Action Potential? Psychology. Web. 03 Mar.