Circulation, Vol 75, 379-386, Copyright © 1987 by American Heart Association
MR Franz, K Bargheer, W Rafflenbeul, A Haverich and PR Lichtlen
T wave concordance in the normal human electrocardiogram (ECG) generally is
explained by assuming opposite directions of ventricular depolarization and
repolarization; however, direct experimental evidence for this hypothesis
is lacking. We used a contact electrode catheter to record monophasic
action potentials (MAPs) from 54 left ventricular endocardial sites during
cardiac catheterization (seven patients) and a new contact electrode probe
to record MAPs from 23 epicardial sites during cardiac surgery (three
patients). All patients had normal left ventricular function and ECGs with
concordant T waves. MAP recordings during constant sinus rhythm or right
atrial pacing were analyzed for activation time (AT) = earliest QRS
deflection to MAP upstroke, action potential duration (APD) = MAP upstroke
to 90% repolarization, and repolarization time (RT) = AT plus APD. AT and
APD varied by 32 and 64 msec, respectively, over the left ventricular
endocardium and by 55 and 73 msec, respectively, over the left ventricular
epicardium. On a regional basis, the diaphragmatic and apicoseptal
endocardium had the shortest AT and the longest APD, and the anteroapical
and posterolateral endocardium had the longest AT and the shortest APD (p
less than .05 to less than .0001). RT was less heterogeneous than APD, and
no significant transventricular gradients of RT were found. In percent of
the simultaneously recorded QT interval, epicardial RT ranged from 70.8 to
87.4 (mean 80.7 +/- 3.9) and endocardial RT ranged from 80 to 97.8 (mean
87.1 +/- 4.4) (p less than .001).(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Monophasic action potential mapping in human subjects with normal electrocardiograms: direct evidence for the genesis of the T wave
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|
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|
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