Cardiac action potential to fail, then the heart could continue to beat, albeit at a lower rate (AVN= 40-60 beats per minute, purkinje fibres = 20-40 beats per minute). These pacemakers will keep a patient alive until the emergency team arrives. An example of premature ventricular contraction, is the classic athletic heart syndrome. Sustained training of athletes causes a cardiac adaptation where the resting SAN rate is lower (sometimes around 40 beats per minute). This can lead to atrioventricular block, where the signal from the SAN is impaired in its path to the ventricles. This leads to uncoordinated contractions between the atria and
Strain rate imaging Cardiac stress test), the regional dysfunction due to ischemia will become evident when the myocardial oxygen demand surpasses the Coronary flow reserve of a stenosed coronary artery. Strain rate imaging during stress has been shown to give incremental value over ordinary echocardiography, both diagnostic and prognostic. In stress echo, the increased heart rate has speckle tracking at a disadvantage, due to the limited frame rate that affects tracking at higher heart rates. In Left bundle branch block (LBBB), the asynchronous activation of the left ventricle gives asynchronous contraction as well. This asynchrony can be visualised by ordinary echocardiography. It can