23.11
心电图(ECG)上记录的电信号出现在心动周期中收缩和舒张等机械过程之前。
心肌动作电位起源于窦房结,并在约0.03秒内扩散至心房和房室结。这在心电图上表现为P波,并触发心房收缩。随后,动作电位在房室结处短暂减慢,使心房得以收缩并将血液充盈至心室,之后心室收缩期才开始。
延迟之后,动作电位迅速通过房室…
心电图(ECG)上记录的电信号发生在心动周期中收缩期和舒张期的机械过程之前。
P波表示动作电位从窦房结传导至心房收缩细胞的过程。
P波后约0.1秒,心房收缩期开始,持续至P-Q间期结束。
P波出现约0.2秒后,QRS波群出现,提示心电冲动已到达心室的收缩细胞,沿室间隔向下传导至心尖,然后向上传导。
心室收缩期始于QRS波群之后,持续整个ST段期间。与此同时,心房进入舒张期。
随后,在P波出现0.4秒后,T波出现,代表心室复极化。T波出现不久后,心室开始舒张。
0.6 秒时,心室完全舒张。接下来的 0.2 秒标志着心房和心室均处于舒张状态的短暂时期。
另一个P波在0.8秒处出现,引发心房收缩并重新启动该周期。
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Q1: What does the P wave represent on an ECG?
The P wave signifies the spread of cardiac action potential from the sinoatrial node to the atrial contractile cells. This electrical signal occurs approximately 0.1 seconds before atrial systole begins. The P wave marks the initiation of atrial contraction during the cardiac cycle.
Q2: How does the QRS complex relate to ventricular activity?
The QRS complex appears approximately 0.2 seconds after the P wave and indicates that cardiac potential has reached the ventricular contractile cells, moving down the septum to the apex, then upward. This electrical event signals the depolarization of the ventricles and triggers ventricular systole, which spans the entire S-T interval on the ECG.
Q3: What is the timing relationship between electrical and mechanical events in the cardiac cycle?
Electrical signals on the ECG precede mechanical processes of contraction and relaxation. The P wave appears before atrial contraction, the QRS complex before ventricular contraction, and the T wave before ventricular relaxation. This delay allows the conduction system of the heart to coordinate the precise sequence of chamber contractions needed for effective blood pumping.
Q4: What does the T wave indicate on an ECG?
The T wave emerges approximately 0.4 seconds after the P wave and signifies ventricular repolarization. Shortly after the T wave appears, the ventricles begin to relax. By 0.6 seconds post-P wave, the ventricles are completely relaxed, marking the end of ventricular systole and the beginning of ventricular diastole.
Q5: How does the AV node delay affect the cardiac cycle?
The action potential is briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before ventricular systole begins. This delay ensures proper coordination between atrial and ventricular contractions. Following this delay, the action potential rapidly propagates through the AV bundle and Purkinje fibers into the ventricles.
Q6: What happens during the period between the T wave and the next P wave?
After the T wave, the ventricles relax completely by 0.6 seconds. The next 0.2 seconds mark a brief period where both the atria and ventricles are relaxed, representing a time of complete cardiac rest. Another P wave appears at 0.8 seconds, initiating atrial contraction and restarting the cardiac cycle.
Q7: How does atrial repolarization appear on an ECG?
Atrial repolarization occurs concurrently with ventricular depolarization following the QRS complex. However, atrial repolarization is usually obscured in an ECG by the more prominent QRS complex. This overlap means the atrial repolarization wave is typically not visible as a distinct feature on standard ECG recordings.