Chávez GE

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Endo-epicardial excitation ends first than the total QRS traces on the electrocardiogram (ECG). In my opinion the phenomenon of synchrony versus electromechanical dyssynchrony began to be understood from the study of Durrer et al. in 1969, published in 1970. Fourteen years later Cassidy et al. mapped a left ventricular endocardial activation demonstrating that the duration of left ventricle (LV) endocardial activation only comprised 41% of the total surface QRS complex on ECG. The aforementioned studies describe ventricular depolarization or QRS duration.
Measurement of the QT-interval on ECG (which represents ventricular depolarization and repolarization) has been proposed for detecting ventricular repolarization. This interval and its dispersion have been more widely studied and spread. Their ionic implications and modifiers of these ion channels have been known. Likewise, thoroughly studies have been conducted on how to perform and interpret their measurements. In the normal heart, M cells located in the middle myocardium, prolong their action potential much more than epicardial or endocardial cells, so there is an electrotonic coupling with the adjacent layers, which coincides with the end of the T wave on ECG.