Research progress and controversy on T wave formation mechanism

Cheng Chen, Yunlong Xia

Article ID: 1904
Vol 2, Issue 2, 2021
DOI: https://doi.org/10.54517/ccr.v2i2.1904
Received: 12 June 2021; Accepted: 28 July 2021; Available online: 13 August 2021; Issue release: 31 December 2021

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Abstract

Although ECG has been developed for a hundred years, the mechanism of T wave formation is unknown. The proposal of in vitro wedge-shaped model has greatly promoted the understanding of T-wave formation mechanism. By comparing the action potentials of epicardial cells, medial cells and endocardial cells in wedge-shaped ventricular mass with the T wave of body surface ECG, it was found that the T wave was mainly formed by the dispersion of transmural repolarization of ventricular muscle. However, in the subsequent in vivo experiments, electrophysiologists found that the formation of T wave was related to the dispersion of ventricular global repolarization, and the repolarization order of different parts of the three-dimensional global heart determined the polarity of T wave. In the real heart, the mechanism of T wave formation may be more complex, its repolarization gradient may include repolarization in each axis of the heart, and the polarity of T wave may also be the result of multiple factors.


Keywords

cardiology; T wave formation; overview; electrophysiology; mechanism


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