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The movement of calcium and sodium ions in and out of cardiac cells is primarily driven by the opening and closing of ion channels during the cardiac action potential. Sodium ions enter the cells rapidly through voltage-gated sodium channels during depolarization, while calcium ions enter through L-type calcium channels, particularly during the plateau phase. The efflux of potassium ions also occurs to repolarize the cell, while the Na+/Ca2+ exchanger and the sodium-potassium pump help maintain ion gradients. These coordinated movements are crucial for the contraction and relaxation of cardiac muscle.

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