Cardiac pacemaker in adult humans is about 70 beats per minute. Because the sinoatrial node is responsible for the rest of the heart's electrical activity, it is sometimes called the "primary pacemaker". If the SA node does not function properly and is unable to control the heart rate, a group of cells further down the heart will become the ectopic pacemaker of the heart. These cells form the Atrioventricular node (or AV node), which is an area between the left atrium and the right ventricle within the atrial septum, will take over the pacemaker responsibility. The cells of the AV node normally
Milrinone of the cardiomyocytes therefore increasing the rate at which cells can depolarize and generate contraction. PKA also phosphorylates components on myofilaments allowing actin and myosin to interact more easily and thus increasing contractility and the inotropic state of the heart. Milrinone allows stimulation of cardiac function independently of β-adrenergic receptors which appear to be down-regulated in those with heart failure. In recent years many studies have been performed showing that milrinone use may present potential adverse side effects in heart failure patients. Milrinone Milrinone, commonly known and marketed under the brand name Primacor, is a medication used in patients who