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Transmural electrophysiological heterogeneity, the T-wave and ventricular arrhythmias

Bas J Boukens1, Richard Walton2, Veronique M Meijborg3

  • 1The Department of Anatomy, Embryology and Physiology, Academic Medical Center, Amsterdam, The Netherlands.

Progress in Biophysics and Molecular Biology
|May 26, 2016
PubMed

Insights

Excessive electrical differences in the heart, known as transmural heterogeneity, can cause arrhythmias and sudden cardiac death. This review explores its origins and role in heart function and disease.

Area of Science:

  • Cardiovascular Physiology
  • Cardiac Electrophysiology
  • Arrhythmogenesis Research

Background:

  • Normal cardiac function relies on heterogeneous electrophysiological distribution.
  • Excessive electrical heterogeneity can lead to arrhythmias and sudden cardiac death.
  • Localization of activation and repolarization gradients in diseased hearts is debated.

Purpose of the Study:

  • To review the genesis and existence of transmural heterogeneity in cardiac activation and repolarization.
  • To explore the embryonic origins of these electrical heterogeneities.
  • To elucidate the role of heterogeneities in electrocardiogram generation and reentrant arrhythmias.

Main Methods:

  • Literature review focusing on transmural electrophysiological heterogeneity.
  • Analysis of embryonic development related to cardiac electrical properties.
  • Examination of pathological conditions involving transmural heterogeneities.

Main Results:

  • Transmural heterogeneity in activation and repolarization is crucial for normal heart function.
  • Abnormal transmural heterogeneity is implicated in arrhythmogenesis.
  • Embryonic development may contribute to the establishment of these heterogeneities.
  • These heterogeneities influence electrocardiogram formation and can precipitate reentrant arrhythmias.

Conclusions:

  • Transmural electrical heterogeneity is fundamental to cardiac function and electrocardiogram generation.
  • Dysregulation of transmural heterogeneity is a significant factor in cardiac arrhythmias and sudden death.
  • Understanding the origins and mechanisms of transmural heterogeneity is vital for developing antiarrhythmic strategies.

Keywords:
Action potential durationActivationEmbryologyPurkinje networkRepolarization

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