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Table 5 The proposed interpretation of ECG patterns

From: A vector-free ECG interpretation with P, QRS & T waves as unbalanced transitions between stable configurations of the heart electric field during P-R, S-T & T-P segments

ECG patterns The proposed interpretation based on displacement of the thoracic electric field center
Description Example
QRS qRS After the septal muscle depolarization, the electric field center moves toward the “DOWN” electrode if the number of positive charges near the “DOWN” electrode is increased (example I), or if the number of positive charges near the “UP” electrode is reduced (example II). I: Right ventricle hypertrophy
II: Left ventricle ischemia
Rs After the septal muscle depolarization, the electric field center moves toward the “UP” electrode if the number of positive charges near the “UP” electrode is increased, or if the number of positive charges near the “DOWN” electrode is reduced. I: Normal heart
II: Left ventricle hypertrophy
QS After the septal muscle depolarization, the electric field center moves and remains near the “DOWN” electrode if the number of positive charges near the “UP” electrode is diminished. Old infarction of the left ventricle wall
RsR’ Initially the left heart structures near the "UP" electrode remain repolarized, while the deeper right ventricle structures normally depolarize and lose positive charges, thus making the R wave. After the normal right ventricle depolarization via the right bundle branch, left ventricle structures are slowly depolarized through the working myocardium. Slow depolarization further imbalances the thoracic electric field and produces S and R' waves. Left bundle branch block
T-wave “Positive” During the ventricular repolarization, the electric field center moves toward the “UP” electrode if the number of positive charges near the “UP” electrode is larger than near the “DOWN” electrode, the amplitude is reduced by the synchronous septal repolarization Normal heart
“Tall” Altered repolarization of the left ventricle wall is delayed and thus less suppressed by the normal septal repolarization Ischemia of the left ventricle wall
“Biphasic”
“Negative” During the ventricular repolarization, the electric field center moves to the “DOWN” electrode if the number of positive charges near the “UP” electrode is smaller than near the “DOWN” electrode.
U- wave Due to rapid ventricle feeling in the early diastole dilates repolarized ventricles, making them a rapidly enlarging source of positive electric field. In individuals with good diastolic compliance, this movement of the ventricle walls can transiently displace the electric field center toward the chest electrode. Often visible in precordial leads