Abstract

This article summarizes the recent experimental and theoretic data regarding the normal electromechanical activation sequence of the left ventricle (LV). First, the cardiac electrical sequence is presented with a brief insight into the wave front of electrical activation that develops from the organized transmural spread of action potentials. Second, the regional heterogeneity in electromechanical coupling and myofiber stretch-shortening kinematics are presented. Finally, the transmural shortening and lengthening sequences are linked with the myofiber architecture of the left ventricular wall to explain the global three-dimensional twisting deformation of the LV. Integrating the electrical and mechanical domains of myocardial function provides vital insights into the macroscopic physiologic behavior of a beating heart.

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