Left ventricular repolarization heterogeneity as an arrhythmic substrate in heart failure

F. G. Akar

Research output: Contribution to journalReview articlepeer-review

4 Scopus citations


Pathophysiological remodeling of cardiac function occurs at multiple levels, spanning the spectrum from molecular and sub-cellular changes to those occurring at the organ-system levels. Of key importance to arrhythmias are changes in the electrophysiological substrate at the tissue level. In this manuscript, we provide an overview of mechanisms by which heterogeneous remodeling of ion channels, calcium handling proteins, gap junctions, and stretchactivated pathways produce functionally significant repolarization gradients across regions (anterior vs lateral) and muscle layers (epicardial vs midmyocardial vs endocardial) of the left ventricule. These repolarization gradients form an electrophysiological substrate that predisposes to arrhythmias and sudden cardiac death in heart failure.

Original languageEnglish (US)
Pages (from-to)205-212
Number of pages8
JournalMinerva Cardioangiologica
Issue number2
StatePublished - Apr 2010


  • Anti-arrhythmia agents
  • Arrhythmias, cardiac
  • Cardiomyopathy dilated
  • Gap junctions
  • Heart failure
  • Ion channels

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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