Table 5 The proposed interpretation of ECG patterns

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.

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