title: Transmural electrophysiological heterogeneity, the T-wave and ventricular arrhythmias.
abstract: Heterogeneous distribution of electrophysiological behavior across the heart is essential for normal cardiac function. If this heterogeneity becomes excessive it may contribute to arrhythmogenesis and sudden cardiac death. Controversy exists regarding the localization of activation and repolarization gradients in the diseased heart and how these heterogeneities contribute to arrhythmogenesis. In this review we focus on the genesis and existence of transmural heterogeneity in activation and repolarization. We will describe a possible embryonic origin of these heterogeneities and address the question how heterogeneities contribute to the genesis of the electrocardiogram and how they may cause reentrant arrhythmias. This review subsequently concentrates on several pathologies in which transmural heterogeneities are thought to play a role.
authors.affiliation: The Department of Anatomy, Embryology and Physiology, Academic Medical Center, Amsterdam, The Netherlands.
authors.forename: Bas J
authors.initials: BJ
authors.lastname: Boukens
authors.affiliation: IHU Institut de Rythmologie et Modélisation Cardiaque, Fondation Bordeaux Université, Bordeaux, France.
authors.forename: Richard
authors.initials: R
authors.lastname: Walton
authors.affiliation: The Department of Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands; ICIN Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands.
authors.forename: Veronique M
authors.initials: VM
authors.lastname: Meijborg
authors.affiliation: IHU Institut de Rythmologie et Modélisation Cardiaque, Fondation Bordeaux Université, Bordeaux, France; The Department of Experimental Cardiology, Academic Medical Center, Amsterdam, The Netherlands. Electronic address: rubencoronel@gmail.com.
authors.forename: Ruben
authors.initials: R
authors.lastname: Coronel
mesh_terms: D000818:Animals; D001145:Arrhythmias, Cardiac / Q000503:physiopathology*; D004562:Electrocardiography; D055724:Electrophysiological Phenomena; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans
keywords: Action potential duration; Activation; Embryology; Purkinje network; Repolarization