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Year: 2014 Volume: 7 Issue: 2

Year: 2014 Volume: 7 Issue: 1

Electrocardiographic T wave and its relation with ventricular repolarization along major anatomical axes.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Meijborg, Veronique M. F. Conrath, Chantal E. Opthof, Tobias Belterman, Charly N. W. de Bakker, Jacques M. T. Coronel, Ruben
Description	Author Affiliation: Meijborg VM ( From the Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands (V.M.F.M., C.E.C., T.O., C.N.W.B., J.M.T.d.B., R.C.)); Conrath CE ( From the Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands (V.M.F.M., C.E.C., T.O., C.N.W.B., J.M.T.d.B., R.C.)); Opthof T ( From the Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands (V.M.F.M., C.E.C., T.O., C.N.W.B., J.M.T.d.B., R.C.)); Belterman CN ( From the Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands (V.M.F.M., C.E.C., T.O., C.N.W.B., J.M.T.d.B., R.C.)); de Bakker JM ( From the Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands (V.M.F.M., C.E.C., T.O., C.N.W.B., J.M.T.d.B., R.C.)); Coronel R ( From the Department of Clinical and Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands (V.M.F.M., C.E.C., T.O., C.N.W.B., J.M.T.d.B., R.C.))
Abstract	BACKGROUND: The genesis of the electrocardiographic T wave is incompletely understood and subject to controversy. We have correlated the ventricular repolarization sequence with simultaneously recorded T waves. METHODS AND RESULTS: Nine pig hearts were Langendorff-perfused (atrial pacing, cycle length 650 ms). Local activation and repolarization times were derived from unipolar electrograms sampling the ventricular myocardium. Dispersion of repolarization time was determined along 4 anatomic axes: left ventricle (LV)-right ventricle (RV), LV:apico-basal, LV:anterior-posterior, and LV:transmural. The heart was immersed in a fluid-filled bucket containing 61 electrodes to determine Tp (Tpeak in lead of maximum integral), TpTe (Tp to Tend), and TpTe_total (first Tpeak in any lead to last Tend in any lead). Repolarization was nonlinearly distributed in time. RT25 (time at which 25% of sites were repolarized, 288±26 ms) concurred with Tp. TpTe was 38±8 ms, and TpTe_total was 75±9 ms. TpTe_total correlated with dispersion of repolarization time in the entire heart (73±18 ms), but not with dispersion of repolarization times along individual axes (LV-RV, 66±17 ms; LV:apico-basal, 51±18 ms; LV:anterior-posterior, 51±27 ms; mean LV:transmural, 14±7 ms; all n=9). CONCLUSIONS: We provide a correlation between local repolarization and T wave in a pseudo-ECG. Repolarization differences along all anatomic axes contribute to the T wave. TpTe_total represents total dispersion of repolarization. At Tp, ≈25% of ventricular sites have been repolarized.
File Format	HTM / HTML
ISSN	19413149
Issue Number	3
Volume Number	7
e-ISSN	19413084
Journal	Circulation: Arrhythmia and Electrophysiology
Language	English
Publisher	Lippincott Williams & Wilkins
Publisher Date	2014-06-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Cardiology Discipline Vascular Diseases Action Potentials Physiology Electrocardiography Heart Conduction System Ventricular Function Animals Electrodes, Implanted Electrophysiologic Techniques, Cardiac Heart Humans Male Models, Animal Reaction Time Sensitivity And Specificity Swine Comparative Study Journal Article Research Support, Non-u.s. Gov't
Content Type	Text
Resource Type	Article
Subject	Physiology (medical) Cardiology and Cardiovascular Medicine

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