Cardiac electrophysiology
Cardiac electrophysiology involves voltage gradients across myocardial cells and their changes during heartbeat cycles. These processes are maintained by ion exchanges across cellular membranes. Their character and dynamics vary for different types of myocytes as well as different layers and strata of cardiac walls. Electrical changes of the cellular membranes of a cell influence neighbouring cells. Electrical excitation that precedes cardiac contraction is propagated throughout the heart in this way, forming the so-called depolarization waveform. The processes of cellular electrical recovery during which the cellular membranes are recharged for the next cardiac cycle do not follow the same path and sequence as the excitation waveform. These recovery processes do not depend on cell-to-cell signal transmission but even during electrical recovery, neighbouring cells influence each other by means of the so-called electrotonic interactions. Abnormalities in electrical excitation due to anatomical blocks and/or functional barriers as well as heterogeneity of the electrical recovery across myocardium may lead to self-perpetuating excitation processes that are the basis of tachyarrhythmias.