Propagation through electrically coupled cells. How a small SA node drives a large atrium.

Each normal cardiac cycle is started by an action potential that is initiated in the sino-atrial (SA) node by automaticity of the SA nodal cells. This action potential then propagates from the SA node into the surrounding atrial cells. We have done numerical simulations of electrically coupled cells to understand how a small SA node can be spontaneously active and yet be sufficiently electrically coupled to the surrounding quiescent atrial cells to initiate an action potential in the atrial cells. Our results with a simple model of two coupled cells and a more complex model of a two-dimensional sheet of cells suggest that some degree of electrical uncoupling of the cells within the SA node may be an essential design feature of the normal SA-atrial system.