This early basic science paper proposes a theoretical framework linking local pH changes and cell membrane polarization to the mechanisms of cardiac conduction and arrhythmias.
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Should not alter arrhythmia management; leaves open whether pH modulation offers therapeutic targets.
In a recent publication¹two of us reported the results of two series of experiments on the isolated perfused heart. Based on these studies we have developed the conception that in the development and propagation of the excitatory process in the heart, thepH of the fluid bathing its tissues is a controlling factor. It is considered that the process of excitation is intimately concerned with changes in the state of equilibrium across the cell membrane. In harmony with the hypothesis advanced by Hermann,²Brunings,³and Bernstein,⁴and more recently elaborated by Lillie,⁵it is suggested that these changes have to do with alterations in the state of polarization existing at the cell tissue fluid interface. The propagation of the excitatory process by means of adjacent tissue by the action current developed at each excited point constitutes "conduction." It is the purpose of this paper to indicate the possible application
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E. P. CARTER (1924) studied this question.
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