title: Global electrical heterogeneity: A review of the spatial ventricular gradient.
abstract: The ventricular gradient, an electrocardiographic concept calculated by integrating the area under the QRS complex and T-wave, represents the degree and direction of myocardial electrical heterogeneity. Although the concept of the ventricular gradient was first introduced in the 1930s, it has not yet found a place in routine electrocardiography. In the modern era, it is relatively simple to calculate the ventricular gradient in three dimensions (the spatial ventricular gradient (SVG)), and there is now renewed interest in using the SVG as a tool for risk stratification of ventricular arrhythmias and sudden cardiac death. This manuscript will review the history of the ventricular gradient, describe its electrophysiological meaning and significance, and discuss its clinical utility.
authors.affiliation: Division of Cardiovascular Medicine, Harvard-Thorndike Electrophysiology Institute, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA. Electronic address: jwaks@bidmc.harvard.edu.
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Waks
authors.affiliation: Knight Cardiovascular Institute, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Larisa G
authors.initials: LG
authors.lastname: Tereshchenko
mesh_terms: D000818:Animals; D018780:Body Surface Potential Mapping / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D006329:Heart Conduction System / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D008955:Models, Cardiovascular; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D062211:Spatio-Temporal Analysis; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology*
keywords: Spatial ventricular gradient; Vectorcardiogram