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 slowly). These channels allow a flow of calcium ions (Ca) into the cell, making the membrane potential more positive. Phase 0 This is the depolarisation phase. When the membrane potential reaches a threshold value (around -20 to -50 mV), it begins to rapidly depolarise (become more positive). This is mainly due to the flow of Ca through the L-type calcium channels, which are now fully open. During this stage the T-type calcium channels and HCN channels deactivate. Phase 3 This phase is the repolarisation phase. This occurs due to the inactivation of the L-type calcium channels (preventing the movement of