Cardiac conduction velocity

Last updated: June 22, 2021

Cardiac conduction velocity

Block 3 CVH

Block 3 CVH

Angina pectoris
Stable angina
Ludwig angina
Unstable angina
Prinzmetal angina
Heart failure
Heart failure: Pathology review
Stroke volume, ejection fraction, and cardiac output
Congestive heart failure: Clinical sciences
Dilated cardiomyopathy
Restrictive cardiomyopathy
Frank-Starling relationship
Myocardial infarction
Acute coronary syndrome: Clinical sciences
ECG cardiac infarction and ischemia
Loop diuretics
Thiazide and thiazide-like diuretics
Potassium sparing diuretics
cGMP mediated smooth muscle vasodilators
ACE inhibitors, ARBs and direct renin inhibitors
Positive inotropic medications
Coronary artery disease: Clinical sciences
Adrenergic antagonists: Beta blockers
Calcium channel blockers
Coronary artery disease: Pathology review
Hereditary spherocytosis
Intrinsic hemolytic normocytic anemia: Pathology review
Extrinsic hemolytic normocytic anemia: Pathology review
Approach to anemia (destruction and sequestration): Clinical sciences
Glucose-6-phosphate dehydrogenase (G6PD) deficiency
Pyruvate kinase deficiency
Paroxysmal nocturnal hemoglobinuria
Warm autoimmune hemolytic anemia and cold agglutinin (NORD)
Lead poisoning
Oxygen-hemoglobin dissociation curve
Sickle cell disease (NORD)
Sickle cell disease: Clinical sciences
Beta-thalassemia
Beta-thalassemia: Year of the Zebra
Alpha-thalassemia
Mitral valve disease
Valvular heart disease: Pathology review
Valvular insufficiency (regurgitation): Clinical sciences
Abnormal heart sounds
Aortic stenosis: Clinical sciences
Aortic valve disease
Infectious endocarditis: Clinical sciences
Acute rheumatic fever and rheumatic heart disease: Clinical sciences
Rheumatic heart disease
Tricuspid valve disease
Pulmonary valve disease
Persistent truncus arteriosus
Transposition of the great vessels
Approach to congenital heart diseases (cyanotic): Clinical sciences
Tetralogy of Fallot
Tetralogy of Fallot: Year of the Zebra
Total anomalous pulmonary venous return
Ventricular septal defect
Approach to congenital heart diseases (acyanotic): Clinical sciences
Atrial septal defect
Patent ductus arteriosus
Acyanotic congenital heart defects: Pathology review
Coarctation of the aorta
Cardiac tumors
Cardiac and vascular tumors: Pathology review
Carcinoid syndrome
Hypertension: Pathology review
Hypertension
Hypertensive emergency
Pulmonary hypertension
Essential hypertension: Clinical sciences
Pulmonary hypertension: Clinical sciences
Approach to hypertension: Clinical sciences
Cor pulmonale
Pulmonary arterial hypertension (NORD)
Cardiomyopathies: Pathology review
Hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy: Clinical sciences
Cardiac conduction velocity
Cardiac conduction system
ECG cardiac hypertrophy and enlargement
ECG axis
ECG intervals
ECG basics
ECG QRS transition
ECG rate and rhythm
ECG normal sinus rhythm
Atrial fibrillation
Supraventricular arrhythmias: Pathology review
Atrial flutter
Ventricular fibrillation
Ventricular arrhythmias: Pathology review
Atrioventricular block: Clinical sciences
Atrioventricular block
Heart blocks: Pathology review
Long QT syndrome and Torsade de pointes
Brugada syndrome
Pericarditis and pericardial effusion
Pericarditis: Clinical sciences
Recurrent pericarditis (NORD)
Pericardial disease: Pathology review
Cardiac tamponade: Clinical sciences
Myocarditis
Shock
Approach to shock: Clinical sciences
Shock: Pathology review
Iron deficiency and iron deficiency anemia (pediatrics): Clinical sciences
Iron deficiency anemia
Iron deficiency anemia: Clinical sciences
Anemia of chronic disease: Year of the Zebra
Anemia of chronic disease
Folate (Vitamin B9) deficiency
Anemia in pregnancy: Clinical sciences
Vitamin B12 deficiency
Vitamin B12 deficiency: Clinical sciences
Orotic aciduria
Diamond-Blackfan anemia
Sideroblastic anemia
Approach to anemia in the newborn and infant (underproduction): Clinical sciences
Acute intermittent porphyria
Porphyria cutanea tarda
Aplastic anemia
Non-hemolytic normocytic anemia: Pathology review
Fanconi anemia
Megaloblastic anemia
Macrocytic anemia: Pathology review
Autoimmune hemolytic anemia
Microcytic anemia: Pathology review
Pernicious anemia: Year of the Zebra
Approach to anemia in the newborn and infant (destruction and blood loss): Clinical sciences
Approach to anemia (underproduction): Clinical sciences
Epstein-Barr virus (Infectious mononucleosis)
Bartonella henselae (Cat-scratch disease and Bacillary angiomatosis)
Acute leukemia
Approach to leukemia: Clinical sciences
Leukemias: Pathology review
Approach to myeloproliferative neoplasms: Clinical sciences
Chronic leukemia
Myeloproliferative disorders: Pathology review
Non-Hodgkin lymphoma
Lymphomas: Pathology review
Approach to lymphoma: Clinical sciences
Hodgkin lymphoma
Multiple myeloma: Clinical sciences
Multiple myeloma
Waldenstrom macroglobulinemia
Plasma cell disorders: Pathology review
Amyloidosis
Monoclonal gammopathy of undetermined significance
Myelodysplastic syndromes
Approach to myelodysplastic syndromes: Clinical sciences
Polycythemia vera (NORD)
Essential thrombocythemia (NORD)
Myelofibrosis (NORD)
Mastocytosis (NORD)
Langerhans cell histiocytosis
Langerhans cell histiocytosis: Year of the Zebra
Non-steroidal anti-inflammatory drugs
Antiplatelet medications
Anticoagulants: Direct factor inhibitors
Thrombolytics
Anticoagulants: Heparin
Heparin-induced thrombocytopenia
Anticoagulants: Warfarin
Osmotic diuretics
Sympatholytics: Alpha-2 agonists
Sympathomimetics: Direct agonists
Wiskott-Aldrich syndrome
Class I antiarrhythmics: Sodium channel blockers
Class II antiarrhythmics: Beta blockers
Class III antiarrhythmics: Potassium channel blockers
Class IV antiarrhythmics: Calcium channel blockers and others
Premature ventricular contraction
Supraventricular tachycardia: Clinical sciences
Wolff-Parkinson-White syndrome
Anatomy clinical correlates: Heart
Approach to bradycardia: Clinical sciences
Premature atrial contraction
Bundle branch block
Approach to a murmur (pediatrics): Clinical sciences
Approach to cyanosis (newborn): Clinical sciences
Cyanotic congenital heart defects: Pathology review
Williams syndrome
Hypoplastic left heart syndrome
Hypoplastic left heart syndrome: Year of the Zebra 2024
Kawasaki disease
Kawasaki disease: Clinical sciences
Approach to chest pain: Clinical sciences
Ventricular tachycardia: Clinical sciences
Approach to syncope: Clinical sciences
Approach to tachycardia: Clinical sciences
Atrioventricular nodal reentrant tachycardia (AVNRT)
Approach to acid-base disorders: Clinical sciences
Acid-base map and compensatory mechanisms
The role of the kidney in acid-base balance
Acid-base disturbances: Pathology review
Plasma anion gap
Approach to metabolic acidosis: Clinical sciences
Metabolic acidosis
Metabolic alkalosis
Respiratory alkalosis
Approach to metabolic alkalosis: Clinical sciences
Approach to respiratory alkalosis: Clinical sciences
Renal tubular acidosis
Respiratory acidosis
Approach to respiratory acidosis: Clinical sciences
Neuroblastoma
Neuroblastoma: Year of the Zebra 2024
Nephroblastoma (Wilms tumor)

Transcript

Watch video only

Cardiac conduction velocity is the velocity at which a depolarization wave moves through the myocardium, the muscular middle layer of the heart, and it’s measured in meters per second.

The depolarization wave travels through the sinoatrial node, or SA node, through both atria, down the atrioventricular or AV node, through the Bundle of His and the Purkinje fibers, and finally to all of the parts of the ventricles, all in about 220 milliseconds, which is less than a quarter of a second!

If we zoom in on the myocardium, the depolarization waves move across neighboring cells. It moves from one cell to the next when ions like calcium and sodium slip through gap junctions and trigger voltage-gated sodium channels in that cell over to open up, allowing a rush of more sodium into the cell and causing an action potential to occur.

That then results in more sodium and calcium leaking through to the next cell, triggering an action potential, which goes on to the next, and so on.

Ultimately these cellular processes determine how fast or slow a depolarization wave will move across different types of tissues.

More sodium channels and gap junctions speed up the depolarization wave, Fewer gap junctions and fewer sodium channels slow down the depolarization wave.

Alright so let’s break down the conduction velocities in the different parts of the heart, starting at the SA node,i the depolarization wave moves through the myocytes in the atria at about 1 meter per second, then goes through the AV node really slowly, roughly between 0.01 and 0.05 meters per second.

Key Takeaways

The cardiac conduction velocity is the speed at which the electrical signal travels through the heart muscle. This electrical signal is generated by the sinoatrial (SA) node, which is located in the right atrium. After getting propagated through booth atria, the signal travels down the atrioventricular (AV) node in the Bundle of His and the Purkinje fibers, and later to all of the parts of the heart ventricles. Cardiac conduction velocity is measured in meters per second (m/s).

The cardiac conduction velocity can be affected by several factors, including age, medications, electrolyte levels, and disease states. Older individuals generally have a slower cardiac conduction velocity, as do those taking certain medications (such as beta blockers). Electrolyte imbalances (such as low potassium levels) can also decrease cardiac conduction velocity. Finally, heart diseases (such as cardiomyopathies) can also result in a slower cardiac conduction velocity.

There are several ways to measure cardiac conduction velocity. The most common method is an electrocardiogram (ECG), which measures the electrical activity of the heart and can be used to determine the cardiac conduction velocity.

Sources

  1. "Physiology" Elsevier (2017)
  2. "Medical Physiology" Elsevier (2016)
  3. "Human Anatomy & Physiology" Pearson (2017)
  4. "Principles of Anatomy and Physiology" Wiley (2014)
  5. "Impact of Sarcoplasmic Reticulum Calcium Release on Calcium Dynamics and Action Potential Morphology in Human Atrial Myocytes: A Computational Study" PLoS Computational Biology (2011)
  6. "The Role of the Funny Current in Pacemaker Activity" Circulation Research (2010)