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Cardiac Action Potential

Cardiac Action Potential

Cardiac action potentials are essential for proper heart function, enabling the rhythmic contractions needed for adequate blood circulation. Nodal cells and Purkinje fibers, specialized for electrical conduction, generate these action potentials.
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials

Potential Energy

Potential Energy

The energy stored by a structure and location of matter in space is called potential energy. For instance, raising a kettlebell changes its spatial location and increases its potential energy. Similarly, a stretched rubber band contains potential energy which, under certain conditions, can be converted into other forms of energy, such as kinetic energy.
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Standard Electrode Potentials

Standard Electrode Potentials

On comparing the reactivity of silver and lead, it is observed that the two ionic species, Ag+ (aq) and Pb2+ (aq), show a difference in their redox reactivity towards copper: the silver ion undergoes spontaneous reduction, while the lead ion does not. This relative redox activity can be easily quantified in electrochemical cells by a property called cell potential. This property is commonly known as cell voltage in electrochemistry, and it is a measure of the energy which accompanies the charge...

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Cell Potential and Free Energy

Thermodynamics of a Redox Reaction
Thermodynamics is the branch of physics dealing with the relationship between heat and other forms of energy. In an electrochemical cell, chemical energy is converted into electrical energy.
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The Resting Membrane Potential

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Electric Potential and Potential Difference

Electric Potential and Potential Difference

Suppose a positive test charge moves away from a positive static charge, then the Coulomb force does positive work, and its electric potential energy decreases. The potential energy per unit charge is defined as the electric potential. The electric potential is independent of the test charge.
When a test charge moves from the initial to the final position, the electric potential difference between those positions is defined as the ratio of the change in the potential energy to the charge on the...

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Evoked potentials improve multimodal prognostication after cardiac arrest.

Pouria Moshayedi¹, Jonathan Elmer², Miguel Habeych³

¹Department of Neurology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.

|April 18, 2019

Summary

Somatosensory evoked potentials (SSEPs) improve predictions of recovery in comatose cardiac arrest survivors. Absent N20 responses in SSEPs significantly alter probabilities for withdrawal of life-sustaining therapy and survival to discharge.

Keywords:

Awakening Cardiac arrest Prognostication Somatosensory evoked potential Survival Withdrawal of life support

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Area of Science:

Neuroscience
Critical Care Medicine
Neurology

Background:

Prognostic assessment in comatose post-cardiac arrest patients is complex.
Absent N20 cortical responses in somatosensory evoked potentials (SSEPs) are a known poor prognostic indicator.
The impact of integrating SSEP results with existing clinical data on recovery prediction remains unclear.

Purpose of the Study:

To determine if SSEP results, specifically the N20 cortical response, alter predicted outcomes when combined with demographic and clinical data.
To evaluate the additive prognostic value of SSEPs in comatose post-cardiac arrest patients.

Main Methods:

A retrospective study of 323 post-cardiac arrest patients.
Logistic regression models were used to predict awakening, withdrawal of life-sustaining therapy (WLST), and survival to discharge, initially with clinical data only.
Upper extremity N20 cortical response results from SSEPs were added to the models to assess updated outcome probabilities.
Receiver operating characteristic (ROC) curves analyzed the additive effect of SSEPs.

Main Results:

The inclusion of SSEPs significantly impacted prognostic predictions.
The proportion of patients with a <1% or <5% chance of survival increased.
The proportion of patients with a >95% chance of WLST also increased.
Area Under the Curve (AUC) for survival prediction improved from 0.85 to 0.93 with SSEP integration (p=0.006).

Conclusions:

Integrating N20 SSEP response data with pre-existing clinical information refines outcome predictions.
SSEPs provide significant additive value in assessing the likelihood of WLST and survival to discharge in comatose post-cardiac arrest patients.