Heart rate node, where the faster pacemaker cells driving the self-generated rhythmic firing and responsible for the heart's autorhythmicity are located. For endurance athletes at the elite level, it is not unusual to have a resting heart rate between 33 and 50 bpm. The "maximum heart rate" (HR) is the highest heart rate an individual can achieve without severe problems through exercise stress, and generally decreases with age. Since HR varies by individual, the most accurate way of measuring any single person's HR is via a cardiac stress test. In this test, a person is subjected to controlled physiologic stress (generally by
Cardiac contractility modulation the electrical non-excitatory state of the cardiac muscle cells (the absolute refractory period) cause an increase in myocyte calcium in the cytosol during systole. This increases the muscle contraction strength. Additionally, within minutes, cell metabolism and gene expression, which are typically abnormal in heart failure, improve towards their normal state. This beneficial effect occurs initially only in the area adjacent to the electrodes, but with time also spreads to remote areas of the cardiac muscle. Cardiac contractility modulation therefore restores the structure and function of damaged cells back towards their normal state. In some cases, disease-related changes in the ventricular