Chronotropic and Dromotropic Responses to Localized Glutamate Microinjections in the Rat $ Nucleus Ambiguus

Total Page:16

File Type:pdf, Size:1020Kb

Chronotropic and Dromotropic Responses to Localized Glutamate Microinjections in the Rat $ Nucleus Ambiguus brain research 1542 (2014) 93–103 Available online at www.sciencedirect.com www.elsevier.com/locate/brainres Research Report Chronotropic and dromotropic responses to localized glutamate microinjections in the rat $ nucleus ambiguus Karla N. Sampaio1,He´lder Mauad2, K. Michael Spyer, Timothy W. Fordn Division of Biosciences, Faculty of Life Sciences, University College London, Gower Street, London WC1E 6BT, UK article info abstract Article history: The cardioinhibitory effects of cardiac vagal motoneurons (CVMs) are mediated by Accepted 18 October 2013 activation of postganglionic neurons in the epicardial ganglia which have been shown to Available online 24 October 2013 exert functionally selective effects on heart rate and atrioventricular conduction in the rat. Here we investigate whether CVMs producing these responses may occupy different Keywords: rostrocaudal positions within the nucleus ambiguus. Excitation of CVMs was attempted Autonomic nervous system by microinjections of glutamate into the nucleus ambiguus of an arterially perfused Vagus nerve preparation in a grid extending over 2 mm in the rostrocaudal plane using the obex as a Nucleus ambiguus reference point. Microinjections were paired, one made during pacing to measure changes Heart rate in atrioventricular conduction (P-R interval) independent of changes in heart rate and the Glutamate other looking for changes in heart period (P-P interval) un-paced. Although evidence of a differential distribution was found in 7 cases, in the majority (13/20), sites producing maximal effects on both variables coincided. Maximal changes in atrioventricular conduc- tion resulted from more rostral sites in 6 cases and from a more caudal site in only one. Overall, the ratio of the change in atrioventricular conduction to the change in heart rate for a given site was significantly greater 1 mm rostral to the obex than at either end of the test grid. We conclude that while CVMs controlling atrioventricular conduction are distributed with a peak somewhat rostral to those controlling heart rate in a number of animals, there is a significant overlap and much greater variability in this distribution in the rat than in cats and dogs. & 2013 The Authors. Published by Elsevier B.V. All rights reserved. Abbreviation: CVM, cardiac vagal motoneuron ☆ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. n Corresponding author. Present address: University of Nottingham School of Health Sciences, South Block Link, Queens Medical Centre, Nottinghamshire NG7 2HA, UK. Fax: þ44 115 823 1211. E-mail address: [email protected] (T.W. Ford). 1Present address: Department of Pharmaceutical Sciences, Federal University of Espírito Santo, Av. Marechal Campos, 1468, Maruípe, Vitória, ES, Brazil. 2Present address: Department of Physiological Sciences, Federal University of Espírito Santo, Av. Marechal Campos, 1468, Maruípe, Vitória, ES, Brazil. 0006-8993/$ - see front matter & 2013 The Authors. Published by Elsevier B.V. All rights reserved. http://dx.doi.org/10.1016/j.brainres.2013.10.035 94 brain research 1542 (2014) 93–103 dromotropic responses with no effects on heart rate were 1. Introduction reported. The present experiments investigate whether differ- ential cardiac effects can be elicited by focal application of The vagus carries the parasympathetic motor supply to the heart glutamate along the rostrocaudal extent of the rat nucleus where it exerts a predominantly inhibitory action. Increased ambiguus while monitoring the effects on heart rate and cardiac vagal activity thus results in a fall not only in the atrioventricular conduction. heart rate (negative chronotropic effect) but also in the rate of A preliminary report has been published in abstract form propagation of the cardiac action potential (negative dromo- (Sampaio et al., 2000). tropic effect) and in the force of myocardial contraction (negative inotropic effect) (see Jones (2001)). The vagal motor path- way comprises a preganglionic component, originating in the medulla oblongata, which in turn synapses with a postganglionic 2. Results component within the cardiac ganglia which are located pre- dominantly in the atrial epicardium. Although axonal tracing 2.1. Effects of microinjections of glutamate studies have shown that mammalian preganglionic cardiac vagal motoneurons (CVMs) arise from the nucleus ambiguus, dorsal Glutamate microinjections commonly elicited changes in motor vagal nucleus and the intermediate reticular formation, heart rate and atrioventricular conduction when the elec- the nucleus ambiguus represents the principal site of origin of trode tip was between 1.5 and 1.8 mm lateral to the midline myelinated cardioinhibitory B-fibers (McAllen and Spyer, 1976, and at a depth of 1.6–1.9 mm depending on the rostrocaudal 1978; Nosaka et al., 1979) while the dorsal motor vagal nucleus level relative to the obex. A representative example of the gives rise to unmyelinated C-fibers which have a lesser effect on time course and extent of changes in P-P and P-R intervals at theheartandlittledemonstrableinputfromthebaroreceptors different rostrocaudal levels is illustrated in Fig. 1. (Ford and McWilliam, 1986; Ford et al., 1990; Jones et al., 1995, Responses typically occurred with an onset latency of less 1998; Nosaka et al., 1982). than 5 s, peaked some 5–30 s later and returned to base- Earlier studies from this laboratory have shown that it is line levels within 1–2 min. The responses were reproducible possible to produce excitation of discrete epicardial ganglia within any series of injections and could not be elicited by resulting in selective effects on the rat heart (Sampaio et al., injections of equivalent volumes of vehicle (20 nL Ringer's 2003). These data are consistent with the existence of func- solution). The sizes of the responses varied quite consider- tionally selective ganglia that have been demonstrated in ably however from one preparation to another. Sites produ- other species (Ardell and Randall, 1986; Gatti et al., 1995, 1997; cing maximal responses were well-localized; microinjections Randall et al., 1986a, 1986b). 0.5–1.0 mm medial or lateral to these sites were typically In the cat, the vagal preganglionic axons running from the ineffective or produced comparatively small responses at nucleus ambiguus to the heart appear to target specific longer onset latencies. Significant increases in both P-P and ganglionic clusters and therefore may also be functionally P-R interval were observed following microinjection of gluta- defined at the preganglionic level (Gatti et al., 1996; Massari mate at all levels of the nucleus ambiguus studied when et al., 1995). That preganglionic CVMs in the rat nucleus compared to pre-injection levels (Table 1). ambiguus may also be functionally specific is suggested by the results of preliminary tracing studies performed in this laboratory. Single discrete microinjections of anterograde 2.2. Rostrocaudal distribution tracers that label small numbers of vagal preganglionic motoneurons in the nucleus ambiguus result in a restricted For each injection level the overall change in P-P interval distribution of labeled axon terminals in the cardiac ganglia (unpaced) is illustrated in Fig. 2A. Comparing the effective- (Jones et al., 1999). While precise mapping of the injection ness of different sites in eliciting changes in P-P interval it sites to anatomically identified ganglia was not performed in can be seen that microinjection of glutamate at 0, þ0.5 and this study, labeled axons were traced running through gang- þ1 induced significantly greater changes in P-P interval lionated plexuses without making any apparent synaptic compared to the other two sites. Changes in P-R interval contact until reaching an apparent target zone where dense however (Fig. 2B) were observed to be significantly greater innervation of neighboring ganglion cells occurred. This only at the levels 0 and þ1.0 compared to the changes elicited suggests that single preganglionic CVMs may preferentially at the most rostral and most caudal sites. To compare the innervate ganglion cells projecting to one particular target relative effectiveness of microinjections on chronotropic and rather than multiple sites within the heart. That such a dromotropic responses, the ratio of the change in P-P interval targeting exists is supported by anterograde tracing experi- to the change in P-R interval (ΔP-R/ΔP-P) was calculated for ments which have shown that CVMs from the left and right all sites where both measurements were made (i.e. micro- sides of the brain stem appear to innervate different subdivi- injections during both unpaced and paced runs). The inten- sions within the cardiac ganglionic plexuses (Cheng et al., tion was to avoid loss of valuable paired data which would 2004). otherwise occur when data were pooled. If the CVMs con- In the study by Gatti et al. (1996), sites in the nucleus trolling P-P interval and those controlling P-R interval were ambiguus producing negative dromotropic effects to gluta- mixed homogeneously across the rostrocaudal extent of the mate tended to be located rostral to those producing negative nucleus then one would not expect to find peaks in this ratio chronotropic effects. In some rostral locations, sites producing at any particular rostrocaudal location. brain research 1542 (2014) 93–103 95 P-P interval P-R interval 300 95 P-P P-R (ms) (ms) 200 85 100 100 60 60 (mmHg) (mmHg) Pressure - 0.5 Pressure -0.5 L-Glu L-Glu 300 95 P-P P-R (ms) (ms) 200 85 100 100 60 60 (mmHg) (mmHg) Pressure Pressure Obex Obex L-Glu L-Glu 300 100 P-R P-P (ms) 200 (ms) 90 100 100 60 60 (mmHg) (mmHg) Pressure Pressure + 0.5 + 0.5 L-Glu L-Glu 300 90 P-R P-P (ms) (ms) 200 80 100 100 60 60 (mmHg) (mmHg) Pressure Pressure + 1.0 + 1.0 L-Glu L-Glu 300 90 P-P P-R (ms) 200 (ms) 80 100 100 60 60 (mmHg) (mmHg) Pressure + 1.5 Pressure + 1.5 L-Glu L-Glu 70 sec 70 sec Fig.
Recommended publications
  • Some Observations on the Atrial Sound*
    15 Oktober 1960 S.A. TYDSKRIF VIR GENEESKUNDE 887 SOME OBSERVATIONS ON THE ATRIAL SOUND* JOHN R BARLOW, M.R, RCH., M.R.C.P., Department of Medicine, University of The WiTwaTersralld. Johallllesburg The atrial sound, also known as the fourth heart sound Emotional factors probably play a large part in this; the or. presystolic gallop, has been defined' as an audible P-G interval may quickly horten again on the introduction ibration occurring more than 0·07 second after the of an intravenous needle or imilar procedure. beginning of the P wave of the simultaneous electrocardio­ 3. EffeCT of respiration. Whereas re piration produce gram (ECG) but preceding the onset of the QRS complex. no effect on the P-G interval in patients with hyperten ion It has been shown' that, unrelated to any alteration in the or ischaemia. the atrial sound of cor pulmonale both in­ P-R interval, the position of the atrial sound varies in creases in intensity and occurs earlier in the cardiac cycle relation to the first heart sound and to the simultaneous during inspiration as compared with expiration (Fig. 4). ECG. 4. EffeCT of various procedures. Jt has already been Jt is the purpose of this paper to demonstrate this mentioned that the intravenous administration of hypo­ variation in the timing of the atrial sound and to discuss tensive drugs will increase the P-G interval in hypertensive some of the clinical implications resulting from this varia­ patients. The inhalation of amyl nitrite has a similar effect bility. in hypertension (Fig. 5), though a change in the P-G METHODS AND OBSERVATIO S interval is seldom seen in cases with ischaemic heart disease following inhalation of this drug.
    [Show full text]
  • Basic Rhythm Recognition
    Electrocardiographic Interpretation Basic Rhythm Recognition William Brady, MD Department of Emergency Medicine Cardiac Rhythms Anatomy of a Rhythm Strip A Review of the Electrical System Intrinsic Pacemakers Cells These cells have property known as “Automaticity”— means they can spontaneously depolarize. Sinus Node Primary pacemaker Fires at a rate of 60-100 bpm AV Junction Fires at a rate of 40-60 bpm Ventricular (Purkinje Fibers) Less than 40 bpm What’s Normal P Wave Atrial Depolarization PR Interval (Normal 0.12-0.20) Beginning of the P to onset of QRS QRS Ventricular Depolarization QRS Interval (Normal <0.10) Period (or length of time) it takes for the ventricles to depolarize The Key to Success… …A systematic approach! Rate Rhythm P Waves PR Interval P and QRS Correlation QRS Rate Pacemaker A rather ill patient……… Very apparent inferolateral STEMI……with less apparent complete heart block RATE . Fast vs Slow . QRS Width Narrow QRS Wide QRS Narrow QRS Wide QRS Tachycardia Tachycardia Bradycardia Bradycardia Regular Irregular Regular Irregular Sinus Brady Idioventricular A-Fib / Flutter Bradycardia w/ BBB Sinus Tach A-Fib VT PVT Junctional 2 AVB / II PSVT A-Flutter SVT aberrant A-Fib 1 AVB 3 AVB A-Flutter MAT 2 AVB / I or II PAT PAT 3 AVB ST PAC / PVC Stability Hypotension / hypoperfusion Altered mental status Chest pain – Coronary ischemic Dyspnea – Pulmonary edema Sinus Rhythm Sinus Rhythm P Wave PR Interval QRS Rate Rhythm Pacemaker Comment . Before . Constant, . Rate 60-100 . Regular . SA Node Upright in each QRS regular . Interval =/< leads I, II, . Look . Interval .12- .10 & III alike .20 Conduction Image reference: Cardionetics/ http://www.cardionetics.com/docs/healthcr/ecg/arrhy/0100_bd.htm Sinus Pause A delay of activation within the atria for a period between 1.7 and 3 seconds A palpitation is likely to be felt by the patient as the sinus beat following the pause may be a heavy beat.
    [Show full text]
  • Electrocardiography: a Technologist's Guide to Interpretation
    CONTINUING EDUCATION Electrocardiography: A Technologist’s Guide to Interpretation Colin Tso, MBBS, PhD, FRACP, FCSANZ1,2, Geoffrey M. Currie, BPharm, MMedRadSc(NucMed), MAppMngt(Hlth), MBA, PhD, CNMT1,3, David Gilmore, ABD, CNMT, RT(R)(N)3,4, and Hosen Kiat, MBBS, FRACP, FACP, FACC, FCCP, FCSANZ, FASNC, DDU1,2,3,5 1Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia; 2Cardiac Health Institute, Sydney, New South Wales, Australia; 3Faculty of Science, Charles Sturt University, Wagga Wagga, New South Wales, Australia; 4Faculty of Medical Imaging, Regis College, Boston, Massachusetts; and 5Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia CE credit: For CE credit, you can access the test for this article, as well as additional JNMT CE tests, online at https://www.snmmilearningcenter.org. Complete the test online no later than December 2018. Your online test will be scored immediately. You may make 3 attempts to pass the test and must answer 80% of the questions correctly to receive 1.0 CEH (Continuing Education Hour) credit. SNMMI members will have their CEH credit added to their VOICE transcript automatically; nonmembers will be able to print out a CE certificate upon successfully completing the test. The online test is free to SNMMI members; nonmembers must pay $15.00 by credit card when logging onto the website to take the test. foundation for understanding the science of electrocardiog- The nuclear medicine technologist works with electrocardio- raphy and its interpretation. graphy when performing cardiac stress testing and gated cardiac imaging and when monitoring critical patients.
    [Show full text]
  • Short PR Intervals and Tachyarrhythmias in Fabry's Disease
    Postgraduate Medical Journal (1986) 62, 285-287 Postgrad Med J: first published as 10.1136/pgmj.62.726.285 on 1 April 1986. Downloaded from Clinical Reports Short PR intervals and tachyarrhythmias in Fabry's disease J. Efthimiou, J. McLelland and D.J. Betteridge Department ofMedicine, University College Hospital, London WCJE6JJ, UK. Summary: Two brothers with Fabry's disease presenting with palpitations were found to have intermittent supraventricular tachycardias. Their electrocardiograms, when symptom-free, revealed short PR intervals consistent with ventricular pre-excitation. Treatment of one of the brothers with verapamil resulted in improvement of the palpitations and reduction in frequency of the tachycardia. Recurrent supraventricular tachycardia associated with ventricular pre-excitation has not previously been described in Fabry's disease. Evidence suggests that this complication may be due to glycolipid deposition in the conducting system around the atrioventricular node. Introduction Fabry's disease (angiokeratoma corporis diffusum) is evidence of heart failure. an X-linked disorder of glycolipid metabolism result The full blood count, erythrocyte sedimentation ing in deposition ofceramide trihexoside, particularly rate, plasma electrolytes, cardiac enzymes, thyroid in the skin, kidneys and cardiovascular system. Car- function tests and chest radiograph were normal. The copyright. diac manifestations are numerous and include rhythm creatinine clearance was reduced at 51 ml/min, but disturbances, myocardial infarction, and congestive or urine analysis was normal with no proteinuria. The rarely hypertrophic cardiomyopathy (Colucci et al., electrocardiogram revealed a short PR interval (0.10 s) 1982). with no delta wave (Figure 1). Electrocardiograms We report on two brothers known to have Fabry's recorded 12 and 5 years earlier revealed normal PR disease who had intermittent tachyarrhythmias with intervals of0.16 s and 0.12 s respectively.
    [Show full text]
  • Basic Cardiac Rhythms – Identification and Response Module 1 ANATOMY, PHYSIOLOGY, & ELECTRICAL CONDUCTION Objectives
    Basic Cardiac Rhythms – Identification and Response Module 1 ANATOMY, PHYSIOLOGY, & ELECTRICAL CONDUCTION Objectives ▪ Describe the normal cardiac anatomy and physiology and normal electrical conduction through the heart. ▪ Identify and relate waveforms to the cardiac cycle. Cardiac Anatomy ▪ 2 upper chambers ▪ Right and left atria ▪ 2 lower chambers ▪ Right and left ventricle ▪ 2 Atrioventricular valves (Mitral & Tricuspid) ▪ Open with ventricular diastole ▪ Close with ventricular systole ▪ 2 Semilunar Valves (Aortic & Pulmonic) ▪ Open with ventricular systole ▪ Open with ventricular diastole The Cardiovascular System ▪ Pulmonary Circulation ▪ Unoxygenated – right side of the heart ▪ Systemic Circulation ▪ Oxygenated – left side of the heart Anatomy Coronary Arteries How The Heart Works Anatomy Coronary Arteries ▪ 2 major vessels of the coronary circulation ▪ Left main coronary artery ▪ Left anterior descending and circumflex branches ▪ Right main coronary artery ▪ The left and right coronary arteries originate at the base of the aorta from openings called the coronary ostia behind the aortic valve leaflets. Physiology Blood Flow Unoxygenated blood flows from inferior and superior vena cava Right Atrium Tricuspid Valve Right Ventricle Pulmonic Valve Lungs Through Pulmonary system Physiology Blood Flow Oxygenated blood flows from the pulmonary veins Left Atrium Mitral Valve Left Ventricle Aortic Valve Systemic Circulation ▪ Blood Flow Through The Heart ▪ Cardiology Rap Physiology ▪ Cardiac cycle ▪ Represents the actual time sequence between
    [Show full text]
  • JUGULAR VENOUS PRESSURE Maddury Jyotsna
    INDIAN JOURNAL OF CARDIOVASCULAR DISEASES JOURNAL in women (IJCD) 2017 VOL 2 ISSUE 2 CLINICAL ROUNDS 1 WINCARS JVP- JUGULAR VENOUS PRESSURE Maddury Jyotsna DEFINITION OF JUGULAR VENOUS PULSE AND The external jugular vein descends from the angle of the PRESSURE mandible to the middle of the clavicle at the posterior Jugular venous pulse is defined as the oscillating top of border of the sternocleidomastoid muscle. The external vertical column of blood in the right Internal Jugular jugular vein possesses valves that are occasionally Vein (IJV) that reflects the pressure changes in the right visible. Blood flow within the external jugular vein is atrium in cardiac cycle. In other words, Jugular venous nonpulsatile and thus cannot be used to assess the pressure (JVP) is the vertical height of oscillating column contour of the jugular venous pulse. of blood (Fig 1). Reasons for Internal Jugular Vein (IJV) preferred over Fig 1: Schematic diagram of JVP other neck veins are IJV is anatomically closer to and has a direct course to right atrium while EJV does not directly drain into Superior vena cava. It is valve less and pulsations can be seen. Due to presence of valves in External Jugular vein, pulsations cannot be seen. Vasoconstriction secondary to hypotension (as in congestive heart failure) can make EJV small and barely visible. EJV is superficial and prone to kinking. Partial compression of the left in nominate vein is usually relieved during modest inspiration as the diaphragm and the aorta descend and the pressure in the two internal
    [Show full text]
  • Vectorcardiographic Changes During Extended Space Flight
    VECTORCARDIOGRAPHIC CHANGES DURING EXTENDED SPACE FLIGHT Raphael F. Smith, M. D. *; Kevin Stanton, M. D. T; David Stoop, M. D. ?; L J. Donald Brown, M.D. 1; Walter Janusz, M.D. and Paul King, Ph.D. * AB ST RACT To assess the effects of space flight on cardiac electrical properties, vectorcardiogram5 were taken on the 9 Skylab astronauts during the flights of 28, 59, and 84 days. The Frank lead system was used and observations were made at rest; during 25%, 50%, and 75% of maximum exercise; during a short pulse of exercise (150 watts, 2 minutes); and after exercise. Data from 131 in-flight tests were analyzed by computer and compared to preflight and postflight values. Statistic- ally significant increase in QRS vector magnitude (six of nine crew- men); T vector magnitude (five of nine crewmen); and resting PR interval duration (six of nine crewmen) occurred. During exercise the PR interval did not differ from preflight. Exercise heart rates in- flight were the same as preflight, but increased in the immediate postflight period. No wajor changes in QRS, T, or ST vector direction occurred. There were sporadic (usual ly i sol ated) ectopic ventri cul ar beats in-flight and one astronaut had a brief episode of ventricular tachycardia 21 days after the first mission. Conclusions: with the exception of the arrhythmias, no deleterious vectorcardiographic changes were observed during the Skylab missions. The increase in QRS and T magnitude resembles the electrocardiographic changes associated with athletic conditioning and may be related to increased ventricular volume secondary to centripetal shifts of fluid and/or the in-flight isotonic exercise program.
    [Show full text]
  • Exercise, the Electrocardiogram, and Peripheral Circulation
    iWorx Physiology Lab Experiment Experiment HH-3 Exercise, the Electrocardiogram, and Peripheral Circulation Note: The lab presented here is intended for evaluation purposes only. iWorx users should refer to the User Area on www.iworx.com for the most current versions of labs and LabScribe2 Software. iWorx Systems, Inc. www.iworx.com iWorx Systems, Inc. 62 Littleworth Road, Dover, New Hampshire 03820 (T) 800-234-1757 / 603-742-2492 (F) 603-742-2455 LabScribe2 is a trademark of iWorx Systems, Inc. ©2013 iWorx Systems, Inc. Experiment HH-3: Exercise, the Electrocardiogram, and Peripheral Circulation Background The arterial system functions as a pressure reservoir. Blood enters via the heart and exits through the capillaries. Signals from the autonomic nervous system control the tone of smooth muscle sphincters around the arterioles. In this way, the autonomic nervous system can control the distribution of blood to the various organs in the body. The distribution of blood that flows to a particular organ is influenced by local conditions. If there are cells that require arterial blood, due to a decline in pH or oxygen levels or an increase in carbon dioxide levels, smooth muscle sphincters open to permit blood into particular capillary beds. At rest, the distribution of blood to a particular organ may be very different from that seen during exercise. For example, the blood flow to the gut decreases during exercise, while blood flow to the skeletal muscles increases dramatically. Furthermore, the amount of blood flowing around the circulatory system may be increased several fold. In this laboratory you will record the electrocardiogram and the finger pulse from a (healthy) subject.
    [Show full text]
  • Dysrhythmias
    CARDIOVASCULAR DISORDERS DYSRHYTHMIAS I. BASIC PRINCIPLES OF CARDIAC CONDUCTION DISTURBANCES A. Standard ECG and rhythm strips 1. Recordings are obtained at a paper speed of 25 mm/sec. 2. The vertical axis measures distance; the smallest divisions are 1 mm ×1 mm. 3. The horizontal axis measures time; each small division is 0.04 sec/mm. B. Normal morphology Courtesy of Dr. Michael McCrea 1. P wave = atrial depolarization a. Upright in leads I, II, III, aVL, and aVF; inverted in lead aVR b. Measures <0.10 seconds wide and <3 mm high c. Normal PR interval is 0.12–0.20 seconds. 2. QRS complex = ventricular depolarization a. Measures 0.06-0.10 seconds wide b. Q wave (1) <0.04 seconds wide and <3 mm deep (2) Abnormal if it is >3 mm deep or >1/3 of the QRS complex. c. R wave ≤7.5 mm high 3. QT interval varies with rate and sex but is usually 0.33–0.42 seconds; at normal heart rates, it is normally <1/2 the preceding RR interval. 4. T wave = ventricular repolarization a. Upright in leads I, II, V3–V6; inverted in aVR b. Slightly rounded and asymmetric in configuration c. Measures ≤5 mm high in limb leads and ≤10 mm high in the chest leads 5. U wave = a ventricular afterpotential a. Any deflection after the T wave (usually low voltage) b. Same polarity as the T wave c. Most easily detected in lead V3 d. Can be a normal component of the ECG e. Prominent U waves may indicate one of the following: (1) Hypokalemia (<3 mEq/L) (2) Hypercalcemia (3) Therapy with digitalis, phenothiazines, quinidine, epinephrine, inotropic agents, or amiodarone (4) Thyrotoxicosis f.
    [Show full text]
  • Ponemah™ Analysis Modules
    About Data Sciences International Start Studies Quickly with Help from Ponemah Analysis Modules DSI Scientific Services ™ Trusted by researchers worldwide to discover Ponemah Analysis Modules new insights into their research applications. DSI can help you streamline your studies by providing expertise you can trust. With our services, we can help Confidence you meet your software validation GLP requirements, DSI is a pioneering biomedical research company focused on preclinical Obtain accurate, consistent results via validated achieve greater implanted telemetry success and systems physiology and pharmacology. The recognized global leader in algorithms developed from scientific and peer- summarize data for confidence in your results. physiologic monitoring, DSI offers telemetry, instrumentation, software reviewed journals and services that facilitate accelerated, well-informed drug therapy and Verify analysis accuracy with real-time visual feedback Data Services development decisions. O perate with full compliance within GLP environments with the Ponemah Data Security Option (DSO) DSI will assist you with creating high quality, useable DSI serves many industries including: Pharmaceuticals, Academia, Speed reports that summarize your experimental data. The reduction in time spent on data analysis and reporting Contract Research Organizations, Biological and Chemical defense, the Efficiently refine results by re-analyzing data processes will provide you with more time to evaluate Medical Device Industry, Government and Biotechnology
    [Show full text]
  • Cardiovascular Physiology
    Introductory Human Physiology © Copyright Emma Jakoi CV 1. HEART ELECTRICAL ACTIVTY Emma Jakoi, Ph.D. LEARNING OBJECTIVES 1. Describe the conduction system of the heart 2. Explain spontaneous electrical activity (pacemaker) in cardiac muscle. 3. Explain action potentials of ventricular cardiac muscle. 4. Explain the cardiac conduction system, pacemakers, and regulation of heart rate by the autonomic nervous system. 5. Explain the ECG and its correspondence to the cardiac action potential (AP). EXCITATION IN CARDIAC MUSCLE The cardiovascular system transports blood containing oxygen, carbon dioxide, nutrients and wastes, between the environment and the cells of the body. It consists of a heart (pump) and blood vessels which deliver nutrients to the tissues (arteries) and ferry waste products away from the tissues (veins). The heart is a muscular organ (Fig 1) which can contract in a rhythmic manner without direct stimulus from the nervous system. Each heart beat begins with the flow of ions across the plasma membrane of the cardiac muscle cell. This current is generated in specialized cells called pacemaker cells. The impulse from the pacemaker cells flows in a unidirectional manner through out the heart via specialized conducting tissue (Fig 1) and into the heart muscle. The electrical impulse results in mechanical contraction of the cardiac muscle through a series of intracellular events involving calcium. Figure 1. Electrical conduction within the heart starts at the sinoatrial (SA) node and passes sequentially to the atriaventricular (AV) node, Bundle of His, left and right bundle branches, and the Purkinje fibers. So the electrical activity moves from the base (A-V junction) to the apex (tip of ventricle) distant from the atria and then sweeps up the sides of the ventricles towards the base.
    [Show full text]
  • Advanced EKG Interpretation JUNCTIONAL RHYTHMS and NURSING INTERVENTIONS Objectives
    Advanced EKG Interpretation JUNCTIONAL RHYTHMS AND NURSING INTERVENTIONS Objectives ♥ Identify specific cardiac dysrhythmias ♥ Describe appropriate nursing interventions for specific dysrhythmias Junctional Rhythms ▪ Junctional rhythms are named such because their impulse originates from the AV node (AV junction) instead of the SA node. ▪ The SA node may be impaired secondary to drug toxicity or underlying cardiac disease. ▪ When the AV node does not sense an impulse coming down from the SA node, it will become the pacemaker of the heart. Characteristics of all Junctional Rhythms ▪ Inverted (negative) or absent P waves are seen before each QRS complex OR ▪ P wave can be hidden in the QRS complex OR ▪ P wave may follow the QRS complex ▪ PR interval of <0.12 seconds (remember normal is 0.12-0.2) ▪ QRS complex within normal measurements Most Common Variations ▪ Junctional (escape) rhythm: 40 - 60 bpm ▪ Accelerated junctional rhythm: 61 – 100 bpm ▪ Junctional tachycardia: >100 bpm ▪ Premature junctional complexes (PJCs) Junctional Rhythm ♥ Junctional (escape) rhythms originate at or around the AV node and the Bundle of His. The impulse travels up the atria and down to the ventricles resulting in inverted P waves that can occur prior to, during or after the QRS. ♥ P waves can also be absent if the impulse does not travel up into the atria. Inverted P wave 5 Steps to Identify Junctional Rhythm 1. What is the rate? 40-60 bpm 2. What is the rhythm? Regular 3. Is there a P wave before each QRS? Are P waves upright Usually inverted or absent, may be before, during or after and uniform? QRS complex 4.
    [Show full text]