Cardiac muscle cell fatigue. There are two types of cells within the heart: the cardiomyocytes and the cardiac pacemaker cells. Cardiomyocytes make up the atria (the chambers in which blood enters the heart) and the ventricles (the chambers where blood is collected and pumped out of the heart). These cells must be able to shorten and lengthen their fibers and the fibers must be flexible enough to stretch. These functions are critical to the proper form during the beating of the heart. Cardiac pacemaker cells carry the impulses that are responsible for the beating of the heart. They are distributed throughout the heart
Cardiac cycle is composed of myocytes which initiate their internal contractions without applying to external nerves—with the exception of changes in the heart rate due to metabolic demand. In an electrocardiogram, electrical systole initiates the atrial systole at the P wave deflection of a steady signal; and it starts contractions (systole) of the ventricles at the Q deflection of the QRS complex. (Completing the P wave represents the end of the "ventricular diastole" and the start of the "ventricular systole"—see cycle diagram). The cardiac cycle involves four major stages of activity: 1) "Isovolumic relaxation", 2) Inflow, 3) "Isovolumic contraction", 4) "Ejection". (See