Figure 1.
Mechanisms underlying the different manifestations of the early repolarization pattern in the ECG. Each panel shows transmembrane action potentials simultaneously recorded from the epicardial and endocardial regions of an arterially-perfused canine left ventricular wedge preparation together with a transmural ECG. Under the conditions indicated, the transmural voltage gradients created by the appearance of an action potential notch in epicardium but not endocardium gives rise to an elevated J wave onset, JO, (A),as distinct J wave (B), slurring to the terminal part of the QRS (C), a distinct J wave together with a ST elevation (D), a gigantic J wave appearing as an ST segment elevation (E). It is under these conditions that we see the development of polymorphic VT (F).Modified from 167, with permission.