The medulla of the brain contains the two cardiac centres; accelerator centre and the inhibitory centre.

The centres send impulses along autonomic nerves which innervate the heart and control the heart rate. Autonomic nerves can be branched into two types; sympathetic and parasympathetic. The accelerator centre sends impulses along the sympathetic nerves whereas the inhibitory centre sends impulses along the parasympathetic nerves. Both these parasympathetic and sympathetic nerves contribute to the cardiac plexus - which is a bundle of nerve fibres situated at the base of the heart. The cardiac plexus can be further divided into two parts - the superficial part which lies beneath the aortic arch and a deep part - which is lies in front of the bifurcation of the trachea. Both the superficial and deep parts are connected... The preganglionic sympathetic nerve fibres reaching the heart arise from the upper four thoracic segments (T1 - T4) of the spinal cord. These fibres then pass to the segmental ganglia in the sympathetic trunk and they synapse at that segmental level (T1 - T4) or ascend up the trunk to the cervical sympathetic ganglia and synapse there. Therefore the postganglionic sympathetic fibres which proceed as bilateral branches from the sympathetic trunk to the cardiac plexus, synapse both directly from the upper four thoracic ganglia and from the neck via the cardiac branches from the cervical sympathetic ganglia. These fibres then pass through the cardiac plexus without synapsing straight to specialised conducting tissues call the sino-atrial node (SA node) and atrioventricular node (AV node) as well as the ventricular myocardium.. Stimulation of the sympathetic nervous system causes an increase in heart rate and also the the force at which the heart contracts. The preganglionic parasympathetic fibers reach the heart as cardiac branches from the right and left vagus nerves (Xth Cranial Nerve). They enter the cardiac plexus and synapse in ganglia located either within the plexus or pass straight through them and innervate the SA node and the AV node. Stimulation of the parasympathetic nervous system decreases heart rate and constriction of the coronary arteries. Overall, both the sympathetic and parasympathetic nerves pass from the cardiac plexus to specialised conducting tissue called the sino-atrial node (SA node), the walls of the atria and the coronary vessels. Afferent pain fibres from heart .... The SA node also known as the cardiac pacemaker, is a group of specialised, conducting cardiac cells located at the superior end of the crista terminalis at the junction of the superior vena cava and the right atrium of the heart. The SA node generates electrical impulses faster than other cells therefore it is responsible for the initiation of the impulse and generate the sinus rhythm (heart beat). These impulses generated by the SA node then spread across the atria causing atrial contraction and thus blood flows into the ventricles. As the atria contract, the ventricles are relaxed because the impulses cannot pass through through the fibrous skeleton of the heart. The impulses then reach the interatrial septum region near the opening of the coronary sinus close to the attachment of the septal cusp of the tricuspid valve, and within the atrioventricular septum. Here there are another group of specialised conducting cardiac cells called the AV node. The impulses form the AV node then travel along the atrioventricular bundle (Bundle of His) which arrives in the inter ventricular septum where it divides into two parts the left and right bundle branches which pass to the respective ventricles. The left branch supplies the papillary muscles in the left ventricle and then spreads out as a network in the ventricular wall and the right branch supplies the base of the anterior papillary muscle. Both branches then branch further to become continuous with the final component of the cardiac conduction system, the subendocardial plexus of ventricular conduction cells or Purkinje fibres. This network of specialized cells spreads throughout the ventricle to supply the ventricle muscles.

Atrial Fibrillation is a form of cardiac arrhythmia (irregular heart beat) where the atria beat out of coordination with the ventricles. Atrial fibrillation is an irregular and usually rapid heart beat that can cause poor blood flow, palpitations and shortness of breath.........