Ventricular escape beat reaching the ventricles (normally initiated by the heart's sinoatrial node (SA node), transmitted to the atrioventricular node (AV node), and then further transmitted to the ventricles) falls below the base rate determined by the rate of Phase 4 spontaneous depolarisation of ventricular pacemaker cells. An escape beat usually occurs 2–3 seconds after an electrical impulse has failed to reach the ventricles. This phenomenon can be caused by the sinoatrial node (SA node) failing to initiate a beat, by a failure of the conductivity from the SA node to the atrioventricular node (AV node), or by atrioventricular block (especially third degree
Sinoatrial node hyperpolarisation-activated cyclic nucleotide–gated (HCN) channels, are activated. Activation of these channels at very negative membrane potential is an unusual property for ion channels, therefore the flow of sodium (Na) and some potassium (K) through the activated HCN channel is referred to as a "funny current" (I). This funny current causes the membrane potential of the cell to gradually increase, as the positive charge (Na and K) is flowing into the cell. Another mechanism involved in pacemaker potential is known as the calcium clock. Here, calcium is released spontaneously from the sarcoplasmic reticulum (a calcium store) into the cell, this is