Anatomy and Function of the Electrical System

The heart's electrical system

In the simplest of terms, the heart is a pump made up of muscle tissue. The heart's pumping action is controlled by an electrical conduction system that coordinates the contraction of the heart chambers.

How does the heart beat?

An electrical stimulus is generated in a specialized part of the heart muscle called the sinus node (also called the sinoatrial node, or SA node). The sinus node is a small mass of specialized tissue located in the right atrium (right upper chamber of the heart). In an adult, the sinus node generates a regular electrical stimulus 60 to 100 times per minute. This electrical stimulus travels down through the conduction pathways and causes the heart's lower chambers (or ventricles) to contract and pump out blood. The right and left atria are stimulated first and contract to push blood from the atria into the ventricles. The ventricles then contract to push blood out into the blood vessels of the body. 

The original electrical impulse travels from the sinus node to the atrioventricular node (also called AV node), located between the atria and the ventricles. In the AV node, the impulses are slowed down for a very short period. This allows the atria to contract a fraction of a second before the ventricles. The blood from the atria empties into the ventricles before the ventricles contract. After passing through the AV node, the electrical current then continues down the conduction pathway, via a pathway called the bundle of His, and into the ventricles. The bundle of His divides into right and left pathways, called bundle branches, to provide electrical stimulation to the right and left ventricles.

Normally at rest, the heart contracts about 60 to 100 times a minute depending on a person's age. In general, your heart rate slows as you age. 

What can go wrong with the heart's electrical system?

Under some abnormal conditions, certain heart tissue is capable of starting a heartbeat, or becoming the "pacemaker," just like the sinus node. An arrhythmia (abnormal heartbeat) may occur when:

  • The heart's natural pacemaker (the sinus node) becomes diseased and slows down

  • The normal conduction pathway is interrupted

  • Another part of the heart takes over as pacemaker resulting in a faster or slower heart beat

Symptoms of an arrhythmia can include heart palpitations, shortness of breath, dizziness, or fainting.

Your doctor may do an ECG (electrocardiogram) to evaluate the rhythm of the heart. This painless test involves recording the electrical activity of your heart with several small stickers attached to your chest. If the electrical rhythm is abnormal, you may need medicine or a procedure.