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A network of specialized muscle cells is found in the heart's walls. These muscle cells send signals to the rest of the heart muscle causing a contraction. This group of muscle cells is called the cardiac conduction system.

The main parts of the system are the SA node, AV node, bundle of HIS, bundle branches, and Purkinje fibers.

Let's follow a signal through the contraction process. The SA node starts the sequence by causing the atrial muscles to contract. That's why doctors sometimes call it the anatomical pacemaker.

Next, the signal travels to the AV node, through the bundle of HIS, down the bundle branches, and through the Purkinje fibers, causing the ventricles to contract.

This signal creates an electrical current that can be seen on a graph called an electrocardiogram, or EKG. Doctors use an EKG to see how well the cardiac conduction system works. Any changes on the EKG can mean serious problems.

Review Date: 5/8/2024
Reviewed By: Thomas S. Metkus, MD, Assistant Professor of Medicine and Surgery, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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