Cardiac pacemaker discharge at about 40-60 beats per minute, and are called the "secondary pacemaker". Further down the electrical conducting system of the heart is the Bundle of His. The left and right branches of this bundle, and the Purkinje fibres, will also produce a spontaneous action potential at a rate of 30-40 beats per minute, so if the SA and AV node both fail to function, these cells can become pacemakers. It is important to realize that these cells will be initiating action potentials and contraction at a much lower rate than the primary or secondary pacemaker cells. The SA node
Contraction band necrosis Contraction band necrosis Contraction band necrosis is a type of uncontrolled cell death (necrosis) unique to cardiac myocytes and thought to arise in reperfusion from hypercontraction, which results in sarcolemmal rupture. It is a characteristic histologic finding of a recent myocardial infarction (heart attack) that was partially reperfused. The name of the histopathologic finding comes from the appearance under the microscope; contraction bands are thick intensely eosinophilic staining bands (typically 4-5 micrometres wide) that span the short axis of the myocyte. They can be thought of extra thick striae, typical of cardiac muscle and striated muscle. Contraction band necrosis is