Global electrical heterogeneity: A review of the spatial ventricular gradient

Jonathan W. Waks, Larisa G. Tereshchenko

Research output: Contribution to journalArticlepeer-review

17 Scopus citations


The ventricular gradient, an electrocardiographic concept calculated by integrating the area under the QRS complex and T-wave, represents the degree and direction of myocardial electrical heterogeneity. Although the concept of the ventricular gradient was first introduced in the 1930s, it has not yet found a place in routine electrocardiography. In the modern era, it is relatively simple to calculate the ventricular gradient in three dimensions (the spatial ventricular gradient (SVG)), and there is now renewed interest in using the SVG as a tool for risk stratification of ventricular arrhythmias and sudden cardiac death. This manuscript will review the history of the ventricular gradient, describe its electrophysiological meaning and significance, and discuss its clinical utility.

Original languageEnglish (US)
Pages (from-to)824-830
Number of pages7
JournalJournal of Electrocardiology
Issue number6
StatePublished - Nov 1 2016
Externally publishedYes


  • Spatial ventricular gradient
  • Vectorcardiogram

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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