Figure 1 shows a single cardiac muscle fiber in four stages of depolarization and repolarization, with the color red designating depolarization. During depolarization, the normal negative potential inside the fiber reverses and becomes slightly positive inside and negative outside.
Fig1. Recording the depolarization wave (A and B) and the repolarization wave (C and D) from a cardiac muscle fiber.
In Figure 1A, depolarization, demonstrated by red positive charges inside and red negative charges outside, is traveling from left to right. The first half of the fiber has already depolarized, while the remaining half is still polarized. Therefore, the left electrode on the outside of the fiber is in an area of negativity, and the right electrode is in an area of positivity, which causes the meter to record positively. To the right of the muscle fiber is shown a record of changes in potential between the two electrodes, as recorded by a high-speed recording meter. Note that when depolarization has reached the halfway mark in Figure 1A, the record has risen to a maximum positive value.
In Figure 1B, depolarization has extended over the entire muscle fiber, and the recording to the right has returned to the zero baseline because both electrodes are now in areas of equal negativity. The completed wave is a depolarization wave because it results from spread of depolarization along the muscle fiber membrane.
Figure 1C shows halfway repolarization of the same muscle fiber, with positivity returning to the outside of the fiber. At this point, the left electrode is in an area of positivity, and the right electrode is in an area of negativity. This polarity is opposite to the polarity in Figure 1A. Consequently, the recording, as shown to the right, becomes negative.
In Figure 1D, the muscle fiber has completely repolarized, and both electrodes are now in areas of positivity so that no potential difference is recorded between them. Thus, in the recording to the right, the potential returns once more to zero. This completed negative wave is a repolarization wave because it results from spread of repolarization along the muscle fiber membrane.
Relation of the Monophasic Action Potential of Ventricular Muscle to the QRS and T Waves in the Standard Electrocardiogram. The monophasic action potential of ventricular muscle, discussed in Chapter 10, normally lasts between 0.25 and 0.35 second. The top part of Figure 2 shows a monophasic action potential recorded from a microelectrode inserted to the inside of a single ventricular muscle fiber. The upsweep of this action potential is caused by depolarization, and the return of the potential to the baseline is caused by repolarization.
Fig2. Top, Monophasic action potential from a ventricular muscle fiber during normal cardiac function showing rapid depolarization and then repolarization occurring slowly during the plateau stage but rapidly toward the end. Bottom, Electrocardiogram recorded simultaneously.
The lower half of Figure 2 shows a simultaneous recording of the ECG from this same ventricle. Note that the QRS waves appear at the beginning of the monophasic action potential and the T wave appears at the end. Note especially that no potential is recorded in the ECG when the ventricular muscle is either completely polarized or completely depolarized. Only when the muscle is partly polarized and partly depolarized does current flow from one part of the ventricles to another part, and therefore current also flows to the surface of the body to produce the ECG.
