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Updated: Apr 18 2018

SA Node Action Potential

Images
https://upload.medbullets.com/topic/108016/images/pacemakeractionpotential.jpg
https://upload.medbullets.com/topic/108016/images/pacemaker_potential_annotated.jpg
https://upload.medbullets.com/topic/108016/images/pacemaker ap.jpg
  • Overview
  • SA Node Action Potential; also AV Node
    • Phase 0, upstroke
      • action potential opens L-type voltage-gated Ca2+ channels
        • secondary to T-type voltage-gated Ca2+ channels further depolarizing cell membrane enough to reach threshold for L-type votage-gated Ca2+ activation → upstroke
        • slope of upstroke is slower than other cardiac myocytes
          • due to lack of large Na+ currents in SA and AV nodal cells
          • due to non-rapid Ca2+ movement via channels
    • Phase 1 and 2 are absent in SA node action potential
    • Phase 3: repolarization
      • voltage-gated K+ channels open → ↑ K+ conductance → outward K+ current → repolarization
    • Phase 4: diastolic depolarization
      • accounts for automaticity of SA node cells
        • to generate an action potential spontaneously without neural input
      • hyperpolarization-activated cyclic nucleotide-gated (HCN) channel generates "funny" current (If)
        • repolarization activates HCN channels
        • non-selective monovalent ion channel
          • evokes Na+ mediated depolarization
        • If slow depolarization activates T-type voltage-gated calcium channels
      • reduced outward K+ current contributes to depolarization
    • Heart rate
      • set by the rate of depolarization in phase 4
        • ↑ rate of phase 4 depolarization → reach threshold faster ↑ action potential per unit time by SA node cells ↑ heart rate
      • pharmacology correlate
        • sympathetic nerveous system stimulation → ↑ heart rate
          • norepinephrine acts on β1 receptors in SA node → ↑ If → ↑ rate of phase 4 depolarization → ↑ heart rate
            • example of a positive chronotropic effect
        • parasympathetic nervous system stimulation → ↓ heart rate
          • acetylcholine acts on M2 receptors in SA node → ↓ If → ↓ rate of phase 4 depolarization → ↓ heart rate
            • also ↑ K+ conductance → ↑ outflow K+ current via K+-ACh receptors
            • an example of a negative chronotropic effect
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