Key result
Endocardial pacing maintains ~43 ms longer subendocardial APD versus subepicardial, compensating for normal activation.
Population
Left ventricular wedge preparations from 10 human donor hearts and in silico simulations
Comparison
Endocardial pacing (1 Hz) vs Epicardial pacing
Design
Preclinical
Authors
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Supports transmural APD gradients aiding repolarization synchrony; leaves open other T-wave mechanisms in humans.
Absolute Event Rate: 360% vs 317%
p-value: p=<0.05
Intrinsic transmural differences in action potential duration synchronize repolarization in the human left ventricle but do not fully explain the genesis of the T wave.
Boukens et al. (2015) studied Normal cardiac electrophysiology (n=10). Endocardial pacing vs. Epicardial pacing was evaluated on Action potential duration (APD) at subendocardium vs subepicardium (p=<0.05). During endocardial pacing, action potential duration was longer at the subendocardium than the subepicardium (360 ± 17 vs. 317 ± 20 ms, P < 0.05), compensating for the normal activation sequence.
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