Cardiovascular Emergencies Part I (1.5 Hours)
Understanding the Heart’s Electrical System
The heart has an internal electrical system that controls the speed and rhythm of the heartbeat. With each heartbeat, an electrical signal spreads from the top of the heart to the bottom. As it travels, the electrical signal causes the heart to contract and pump blood. The process repeats with each new heartbeat. Each electrical signal begins in a group of cells called the sinus node, or sinoatrial (SA) node. The SA node is located in the right atrium (AY-tree-um), which is the upper right chamber of the heart. In a healthy adult heart at rest, the SA node fires off an electrical signal to begin a new heartbeat 60 to 100 times a minute.
From the SA node, the electrical signal travels through special pathways to the right and left atria. This causes the atria to contract and pump blood into the heart’s two lower chambers, the ventricles. The electrical signal then moves down to a group of cells called the atrioventricular (AV) node, located between the atria and the ventricles. Here, the signal slows down just a little, allowing the ventricles time to finish filling with blood. The electrical signal then leaves the AV node and travels along a pathway called the bundle of His. This pathway divides into a right bundle branch and a left bundle branch. The signal goes down these branches to the ventricles, causing them to contract and pump blood out to the lungs and the rest of the body. The ventricles then relax, and the heartbeat process starts all over again in the SA node.
A problem with any part of this process can cause an arrhythmia. For example, in atrial fibrillation, a common type of arrhythmia, electrical signals travel through the atria in a fast and disorganized way. This causes the atria to quiver instead of contract. There are many different types of arrhythmia. Most arrhythmias are harmless but some are not. The outlook for a person with an arrhythmia depends on the type and severity of the arrhythmia. Even serious arrhythmias can often be successfully treated. Most people with arrhythmias are able to live normal, healthy lives.
