The Heart Has Several Pacemakers Known As Autonomic Foci

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The heart has several pacemakers known as autonomic foci, each which fires at its own essential rate:

The potentials will normally travel in order SA node atrial foci junctional foci ventricular
foci. Pacemaker potentials are fired not only by SA node, but also by the other foci. However, the
other firing frequencies are slower than the one of the SA node. Normally, all the foci will end up
firing at the SA node rate, not their essential rate. The other foci attempt to fire at their essential rate,
but they are activated by the SA node before they can fire. This rapid firing causes all the foci to fire
faster than their essential rates, a phenomenon known as overdrive-suppression. Thus, in the normal,
healthy heart, only the SA node essential rate is observable. However, in pathological
conditions, the essential rate becomes apparent. Consider a heart attack which
damages the region of the heart between the SA node and the atrial foci:
Sinoatrial node |block| atrial foci junctional foci ventricular foci. The other
foci will not see the SA node firing; however, they will see the atrial foci. The
heart will now beat at the essential rate of the atrial foci.

In the pacemaking cells of the heart , the pacemaker potential is the slow,
positive increase in voltage across the cell's membrane that occurs between the
end of one action potential and the beginning of the next action potential. This
increase in membrane potential is what causes the cell membrane, which
typically maintains a resting membrane potential of -70 mV, to reach the
threshold potential and trigger the next action potential, therefore the
pacemaker potential is what drives the self-generated rhythmic firing of
pacemaker cells. The sinoatrial node is a complex tissue within the right atrium
containing pacemaker cells that normally determine the intrinsic firing rate for
the entire heart, the pacemaker potential is the main determinant of the heart
rate. Because the pacemaker potential represents the non-contracting time
between heart beats (diastole), it is also called the diastolic depolarization. The
amount of net inward current required to move the cell membrane potential
during the pacemaker phase is extremely small but this net flux arises from time
to time changing contribution of several currents that flow with different voltage
and time dependence. Evidence of support of the active presence of K +, Ca2+, Na+
channels and Sodium pump mechanism.

References
Campbell, Neil. A (1996). Biology. Benjamin Cummings. p. G21.
Boron, Walter. F; Emile Boulpaep (2003). Medical Physiology. Elsevier Saunders.
p. 487

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