• DOI:10.1152/ajpheart.01241.2010
• Corpus ID: 15788476

Transmural and apicobasal gradients in repolarization contribute to T-wave genesis in human surface ECG.

@article{Okada2011TransmuralAA,
  title={Transmural and apicobasal gradients in repolarization contribute to T-wave genesis in human surface ECG.},
  author={Jun-ichi Okada and Takumi Washio and Akiko Maehara and Shin‐ichi Momomura and Seiryo Sugiura and Toshiaki Hisada},
  journal={American journal of physiology. Heart and circulatory physiology},
  year={2011},
  volume={301 1},
  pages={
          H200-8
        }
}

• J. Okada, T. Washio, +3 authors T. Hisada
• Published 1 April 2011
• Biology
• American journal of physiology. Heart and circulatory physiology

The cellular basis of the T-wave morphology of surface ECG remains controversial in clinical cardiology. We examined the effect of action potential duration (APD) distribution on T-wave morphology using a realistic model of the human ventricle and torso. We developed a finite-element model of the ventricle consisting of ∼26 million elements, including the conduction system, each implemented with the ion current model of cardiomyocytes. This model was embedded in a torso model with distinct organ structures to obtain the standard ECG leads. The APD distribution was changed in the transmural direction by locating the M cells in either the endocardial or epicardial region. We also introduced apicobasal gradients by modifying the ion channel parameters. Both the transmural gradient (with M cells on the endocardial side) and the apicobasal gradient produced positive T waves, although a very large gradient was required for the apicobasal gradient. By contrast, T waves obtained with the transmural gradient were highly symmetric and, therefore, did not represent the true physiological state. Only combination of the transmural and the moderate apicobasal gradients produced physiological T waves in surface ECG. Positive T waves in surface ECG mainly originated from the transmural distribution of APD with M cells on the endocardial side, although the apicobasal gradient was also required to attain the physiological waveform.