Measuring the T Wave of the Electrocardiogram; The How and Why

A. van Oosterom

doi:10.2478/v10048-009-0011-9

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Measuring the T Wave of the Electrocardiogram; The How and Why

Measurement Science Review

Volume 9 (2009): Issue 3 (June 2009)

By: A. van Oosterom

Open Access

|Jul 2009

Abstract

The genesis of the T wave of the electrocardiogram is discussed on the basis of a biophysical model, derived from the underlying electrophysiology. This model is used to scrutinize the commonly-assumed significance of the individual features of this waveform. As is shown, the last word is yet to be said about this topic.

References

Einthoven, W., de Lint, K. (1900). Ueber das normale menschliche Elektrokardiogram und Uber die capillarelektrometrische Untersuchung einiger Herzkranken. Pflugers Arch. ges. Physiol., 80, 139-160.10.1007/BF01663110
Search in Google Scholar
Ritsema van Eck, H.J., Kors, J.A., van Herpen, G. (2005). The U wave in the electrocardiogram: a solution for a 100-year-old riddle. Cardiovasc. Res., 67, 256-262.10.1016/j.cardiores.2005.04.010
Search in Google Scholar
di Bernardo, D., Murray, A. (2002). Origin on the electrocardiogram of U-waves and abnormal U-wave inversion. Cardiovasc. Res., 53, 202-208.10.1016/S0008-6363(01)00439-4
Search in Google Scholar
Schalij, M.J., et al. (eds.) (2002). Einthoven 2002: 100 Yeart of Electrocardiography. Leiden, Netherlands: The Einthoven Foundation, 616.
Search in Google Scholar
Webster, J. (ed.) (1998). Medical Instrumentation, Application and Design. 3 ed. New York: Wiley.
Search in Google Scholar
MettingVanRijn, A.C., Kuiper, A.P., Linnenbank, A.C., Grimbergen, C.A. (1993). Patient isolation in multichannel bioelectric recordings by digital transmission through a single optical fiber. IEEE Trans. Biomed. Eng., 40 (3), 302-8.10.1109/10.216416
Search in Google Scholar
Winter, B.B., Webster, J.G. (1983). Driven-right-leg circuit design. IEEE Trans. Biomed. Eng., 30 (1), 62-66.10.1109/TBME.1983.325168
Search in Google Scholar
Macfarlane, P.W. (1989). Lead systems. In Marfarlane, P.W., Lawrie, T.D.V. (eds.) Comprehensive Electrocardiology: Theory and Practice in Health and Disease. Pergamon Press, 315-352.
Search in Google Scholar
Hoekema, R., Uijen, G.J.H., van Oosterom, A. (1999). The number of independent signals in body surface maps. Meth. Inform. Med., 38 (2), 119-124.
Search in Google Scholar
Taccardi, B. (1963). Distribution of heart potentials on the thoracic surface of normal human subjects. Circ. Res., 12, 341-352.10.1161/01.RES.12.4.341
Search in Google Scholar
Macfarlane, P.W. (1989). Normal limits. In Macfarlane, P.W., Lawrie, T.T.V. (eds.) Comprehensive Electrocardiology: Theory and Practice in Health and Disease. Vol. 3. Pergamon Press, 1441-1526.
Search in Google Scholar
Jackman, W.M., Friday, K.J., Anderson, J.L., Aliot, E.M., Clark, M., Lazzara, R. (1988). The long QT syndromes: a critical review, new clinical observations and a unifying hypothesis. Prog. Cardiovasc. Dis., 31 (2), 115-172.10.1016/0033-0620(88)90014-X
Search in Google Scholar
Antzelevitch, C., et al. (2003). Brugada syndrome: 1992-2002. J. Am. Coll. Cardiol., 41 (10), 1665-1671.10.1016/S0735-1097(03)00310-3
Search in Google Scholar
Gussak, I., Antzelevitch, C. (2000). Early repolarization syndrome: clinical characteristics and possible cellular and ionic mechanisms. J. Electrocardiol., 33, 299-309.10.1054/jelc.2000.1810611099355
Search in Google Scholar
Faes, T.J.C. (1992). Assessment of Cardiovascular Autonomic Function. An Inquiry into Measurement. PhD Thesis, Vrije Universiteit Amsterdam.
Search in Google Scholar
Wilson, F.N., Macleod, A.G., Barker, P.S. (1933). The distribution of action currents produced by the heart muscle and other excitable tissues immersed in conducting media. J. Gen. Physiol., 16, 423-456.10.1085/jgp.16.3.423214121919872716
Search in Google Scholar
Plonsey, R. (1965). An extension of the solid angle formulation for an active cell. Biophysical J., 5, 663-666.10.1016/S0006-3495(65)86744-3
Search in Google Scholar
Smythe, W.R. (1968). Static and Dynamic Electricity. New York: McGraw-Hill.
Search in Google Scholar
Panofski, W.K.H., Phillips, M. (1962). Classical Electricity and Magnetism. London: Addison-Wesley.
Search in Google Scholar
Geselowitz, D.B. (1989). On the theory of the electrocardiogram. Proc. IEEE, 77 (6), 857-876.10.1109/5.29327
Search in Google Scholar
van Oosterom, A. (2009). The equivalent double layer; source model for repolarization. In Macfarlane, P.W., et. al. (eds.) Comprehensive Electrocardiology. Vol. 1. New York: Springer.
Search in Google Scholar
Geselowitz, D.B. (1992). Description of cardiac sources in anisotropic cardiac muscle. Application of bidomain model. J. Electrocardiol., 25 Suppl., 65-67.10.1016/0022-0736(92)90063-6
Search in Google Scholar
Gulrajani, R.M. (1998). Bioelectricity and Biomagnetism. New York: John Wiley & Sons.
Search in Google Scholar
Barr, R.C., Ramsey, M., Spach, M.S. (1977). Relating epicardial to body surface potentials by means of transfer coefficients based on geometry measurements. IEEE Trans. Biomed. Eng., 24, 1-11.10.1109/TBME.1977.326201832882
Search in Google Scholar
Oostendorp, T.F., van Oosterom, A. (1989). Source parameter estimation in inhomogeneous volume conductors of arbitrary shape. IEEE Trans. Biomed. Eng., 36, 382-391.10.1109/10.198592921073
Search in Google Scholar
Huiskamp, G.J.M. (1998). Simulation of depolarization and repolarization in a membrane-equations-based model of the anisotropic ventricle. IEEE Trans. Biomed. Eng., 45 (7), 847-855.10.1109/10.6867929644893
Search in Google Scholar
van Dam, P.M., van Oosterom, A. (2005). Volume conductor effects involved in the genesis of the P wave. Europace, 7, S30-S38.
Search in Google Scholar
Huiskamp, G.J.M., van Oosterom, A. (1989). The depolarization sequence of the human heart surface computed from measured body surface potentials. IEEE Trans. Biomed. Eng., 35 (12), 1047-1058.
Search in Google Scholar
van Dam, P.M., et al. (2009). Non-invasive imaging of cardiac activation and recovery. Ann. Biomed. Eng, (in press).
Search in Google Scholar
Fischer, G., et al. (2005). A signal processing pipeline for noninvasive imaging of ventricular preexcitation. Meth. Inform. Med., 44, 588-515.
Search in Google Scholar
van Oosterom, A. Oostendorp, T. (2004). ECGSIM; an interactive tool for studying the genesis of QRST waveforms. Heart, 90, 165-168.10.1136/hrt.2003.014662176808514729788
Search in Google Scholar
van Oosterom, A., Jacquemet, V. (2005). A parameterized description of transmembrane potentials used in forward and inverse procedures. In Int. Conf. Electrocardiol. Gdansk, Poland: Folia Cardiologica.
Search in Google Scholar
Haws, C.W., Lux, R.L. (1990). Correlation between in vivo transmambrane action potential durations and activation-recovery intervals from electrograms. Circulation, 81 (1), 281-288.10.1161/01.CIR.81.1.281
Search in Google Scholar
Durrer, D., et al. (1970). Total excitation of the isolated human heart. Circulation, 41, 899-912.10.1161/01.CIR.41.6.8995482907
Search in Google Scholar
Franz, M.R., et al. (1987). Monophasic action potential mapping in a human subject with normal electrograms: direct evidence for the genesis of the T wave. Circulation, 75 (2), 379-386.10.1161/01.CIR.75.2.379
Search in Google Scholar
Cowan, J.C., et al. (1988). Sequence of epicardial repolarization and configuration of the T wave. Br. Heart J., 60, 424-433.10.1136/hrt.60.5.42412166013203037
Search in Google Scholar
Ihara, Z., van Oosterom, A., Hoekema, R. (2006). Atrial repolarization as observable during the PQ interval. J. Electrocardiol., 39, 290-297.10.1016/j.jelectrocard.2005.12.00116650429
Search in Google Scholar
van Oosterom, A. (2002). The singular value decomposition of the T wave: its link with a biophysical model of repolarization. Int. J. Bioelectromagnetism, 4, 59-60.
Search in Google Scholar
Janse, M.J., et al. (1980). Flow of injury current and patterns of excitation during early ventricular arrhythmias in acute regional myocardial ischemia in isolated porcine and canaine hearts; evidence for two different arrhythmogenic mechanisms. Circ. Res., 47, 151-165.10.1161/01.RES.47.2.151
Search in Google Scholar

Articles in this issue

DOI: https://doi.org/10.2478/v10048-009-0011-9 | Journal eISSN: 1335-8871

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Language: English

Page range: 53 - 63

Published on: Jul 21, 2009

Published by: Slovak Academy of Sciences, Institute of Measurement Science

In partnership with: Paradigm Publishing Services

Publication frequency: Volume open

Keywords:

T wave morphology,

QT level abnormalities,

Timing Apex,

T wave duration

Related subjects:

Engineering,

Electrical engineering,

Control engineering, metrology and testing

© 2009 A. van Oosterom, published by Slovak Academy of Sciences, Institute of Measurement Science
This work is licensed under the Creative Commons License.

Volume 9 (2009): Issue 3 (June 2009)