Ionic basis of electrical activity in cardiac tissues.

Cardiac electrical events are described in terms of membrane physiology. The concept that cardiac membranes possess specific ionic channels controlled by gates bearing electrical charges is discussed. When open, these channels permit ions to cross the membrane, giving rise to passive inward (depolarizing) and outward (repolarizing) currents. Two different inward and four or five different outward currents appear to be responsible for the development of cardiac electrical activity; both inward currents appear to be controlled by activation and inactivation variables, whereas outward currents are essentially controlled by activation variables and/or inward-going rectifiers. The potential range in which the different currents activate and inactivate (or are limited by inward-going rectification), and the kinetics of activation and inactivation processes explain the development of electrical activity in normal cardiac tissues and in partially depolarized fibers. In addition to passive ionic currents, electrogenic active transport participates in the development of electrical phenomena. The conductance of the membrane for potassium ions and the electrical coupling between cardiac cells depend on the intracellular concentration of calcium ions.