Transmural repolarization does not underlie the T-wave in the human heart. Correlation between in vivo data and computer simulations

Abstract

The concordance of the QRS complex and the T wave in the ECG is considered to result from the opposite direction of the transmural activation and repolarization fronts resulting in earlier repolarization at the epicardial surface. In fact there are no data which support early epicardial repolarization time (RT) in man. Therefore, the explanation for this concordance is based on a surmise. We have assessed subepicardial vs. subendocardial RT in (i) 21 patients, in (ii) a Langendorff-perfused explanted human heart and in (iii) computer simulations based on the Priebe-Beuckelmann model of the ventricular human myocyte.