Evaluation of spacial heterogeneous distribution of ventricular repolarization and arrhythmic risk by the body surface standard electrocardiogram

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Fatal ventricular tachyarrhythmias often originate from enlargement of ventricular transmural dispersion of repolarization (TDR). Using canine model which showed spacial heterogeneous distribution of ventricular repolarization, we studied the relationship between the interval of the peak-to-end of the T wave (Tp-e) in ECG and the 3-dimensional repolarization heterogeneity. Tp-e in the limb leads expresses total distribution of repolarization in the left ventricle (LV). The proportion of variance of TDR in each LV region for Tp-e on V2-4 were higher in the anterior rather than in the lateral region, while those on V5-6 were higher in the lateral or midventricular/apical region rather than in the anterior or basal region. The precordial Tp-e seemed to express a certain degree of TDR at near and vertical ventricular wall. These results elucidated the electrophysiological background of the T wave and showed the alternative method of the discrimination of the fatal arrhythmic risk.