Circulation, Vol 51, 1030-1037, Copyright © 1975 by American Heart Association
Y Watanabe
Our recent clinical studies suggest that the U wave represents Purkinje
repolarization. To test this hypothesis, transmembrane potentials of
Purkinje fibers (P) and the ventricular muscle (V) were simultaneously
recorded from canine P-V preparations perfused in a tissue bath, and
effects of various factors causing prominent U waves were studied. These
include low stimulating frequency (bracycardia), low potassium (K)
concentration, hypothermia, and quinidine. Bracycardia increased the
difference between action potential duration of P and V, and decreased the
rate of repolarization in P. Similarly, the difference of P and V action
potential duration was increased markedly by low K and hypothermia, and
slightly by quinidine, while the slope of phase 3 was significantly
decreased by all these factors. In several intact animals either
hypokalemia or hypothermia was produced using hemodialysis or
extracorporeal circulation, and recorded electrocardiograms were compared
with the P and V action potentials obtained under similar perfusing
conditions in subsequent tissue bath study. Such comparison revealed a good
temporal correlation between phase 3 repolarization in P and the
electrocardiographic U wave. These results, although indirect, appear to
support the theory that P repolarization caused the genesis of the U wave.
ARTICLES
Purkinje repolarization as a possible cause of the U wave in the electrocardiogram
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