Cardiac action potential

The cardiac action potential is a brief change in voltage (membrane potential) across the cell membrane of heart cells. This is caused by the movement of charged atoms (called ions) between the inside and outside of the cell, through proteins called ion channels. The cardiac action potential differs to action potentials found in other types of electrically excitable cells, such as nerves, as well as varying within the heart also, this is due to the presence of different ion channels in different cells (see below).

Unlike the action potential in skeletal muscle cells, the cardiac action potential is not initiated by nervous activity. Instead, it arises from a group of specialized cells, that have automatic action potential generation. In healthy hearts, these cells are found in the right atrium and are called the sinoatrial node (SAN; see below for more details). They produce roughly 60-100 action potentials every minute. This action potential passes along the cell membrane causing the cell to contract, therefore the activity of the SAN results in a resting heart rate of roughly 60-100 beats per minute. All cardiac muscle cells are electrically linked to one another, by structures known as gap junctions (see below) which allow the action potential to pass from one cell to the next. This means that all atrial cells can contract together, and then all ventricular cells.

Rate dependence of the action potential is a fundamental property of cardiac cells and alterations can lead to severe cardiac diseases including cardiac arrhythmia and sometimes sudden death. Action potential activity within the heart can be recorded to produce an electrocardiogram (ECG). This is a series of upward and downward spikes (labelled P, Q, R, S and T) that represent the depolarization (voltage becoming more positive) and repolarization (voltage becoming more negative) of the action potential in the atria and ventricles (see electrocardiography for more details).

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