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© 2004 Australasian Society of Cardiac and Thoracic Surgeons and the Cardiac Society of Australia and New Zealand. Published by Elsevier Inc. All rights reserved.
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- Pacing Staircase Phenomenon in the Heart: From Bodwitch to the XXI CenturyHeart, Lung and CirculationVol. 13Issue 4
- PreviewThe frequency of pacing is a fundamental physiological modulator of myocardial function. When the pacing rate increases there is normally an increase in contractility (a positive force–frequency relationship). However in small rodents, fish and end-stage failing myocardium, the force–frequency response has been found to be flat or even negative. The positive staircase is understood to be related with the increase in the intracellular Ca2+ transient, mainly due to an enhanced sarcoplasmic reticulum Ca2+ content at higher stimulation frequencies, resulting from an increase in Ca2+ influx per unit time and reduced Ca2+ efflux between beats.