Hoffman Irwin
Lovelace Medical Center, S.E., Albuquerque, NM 87108, USA.
Med Hypotheses. 2005;65(5):851-8. doi: 10.1016/j.mehy.2005.06.010.
The T-wave of the electrocardiogram (ECG) is generated both from the left and the right ventricles of the heart. Each ventricle may produce a normal, an "ischemic", or a "secondary" T-wave, depending on segmental perfusion, intraventricular pressure, or QRS complex duration. The direction of the T-wave is determined by the particular inward rectifier potassium channels recruited by various layers and segments in the two ventricles. The observed T-wave in the clinical ECG is the summation of the left and right ventricular T waves, and is thus biventricular. Clinical observations in right bundle branch block (RBBB) and in right ventricular hypertensive states such as pulmonary embolism suggest that many ECG's interpreted as inferior or anterior left ventricular ischemia are in fact examples of abnormal potassium channel recruitment in the right ventricle. Consideration of the right ventricular component of the T-wave in every electrocardiographic interpretation improves diagnostic understanding and accuracy, as the possible right ventricular origin of observed anterior or superior T waves will not be overlooked.
心电图（ECG）的T波由心脏的左、右心室共同产生。每个心室可能产生正常的、“缺血性”的或“继发性”的T波，这取决于节段性灌注、心室内压力或QRS波群持续时间。T波的方向由两个心室中各层和各节段募集的特定内向整流钾通道决定。临床心电图中观察到的T波是左、右心室T波的总和，因此是双心室的。右束支传导阻滞（RBBB）以及右心室高血压状态（如肺栓塞）的临床观察表明，许多被解释为下壁或前壁左心室缺血的心电图实际上是右心室钾通道募集异常的例子。在每次心电图解读中考虑T波的右心室成分，可提高诊断的理解和准确性，因为观察到的前T波或上T波可能的右心室起源不会被忽视。
