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Unmasking the J-wave: 3D ECG shows terminal depolarization mimicking early repolarization
Alejandro Jesús Bermejo Valdés1
1Riojan Health Service, Logroño, Spain.
None:
We used three-dimensional (3D) electrocardiography (ECG) to track the J-wave in V6 through viewing planes inaccessible to standard ECG. Across three identified J-loop phenotypes, we found that the planar morphology of the end QRS deflection, whether J-wave or slurring, depended on projection and was interconvertible under rotation. Although traditionally attributed to phase-1 of the action potential, the 3D J-loop showed that the J-wave becomes concealed and occupies depolarization regions in V1. Here, we examine this discrepancy and show that 3D ECG can more accurately reinterpret the electrophysiological and pathological phenomena associated with early repolarization.
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