Cellular Electrophysiology and Ischemia

  • Ralph Lazzara
  • Benjamin J. Scherlag
Part of the Developments in Cardiovascular Medicine book series (DICM, volume 34)


The conspicuous effects of ischemia on the electrocardiogram quickly caught the attention of clinicians who exploited them to diagnostic advantage. These electrocardiographic changes called for an explanation, which meant a description of the cellular electrophysiologic changes during ischemia that generated the electrocardiographic abnormalities. Although direct evidence bearing on the problem was scarce, constructs and schemas were plentiful. Textbooks of electrocardiography proudly displayed resting and action potentials from ischemic cells even before the technology for intracellular recording was well developed. The bases for these conceptions were the wellknown depolarizing effect of injury on excitable cells and the idea that the duration of the action potential of ischemic cells was abbreviated. Explanations were built on the perception that the basic changes produced by ischemia were few and simple: partial depolarization, abbreviation of the action potential, or total loss of electrical activity because of cell death. Even after the development of intracellular recording, direct observations of cellular electrophysiologic changes during ischemia have been difficult and sparce. The true condition of ischemia occurs in the setting of the beating heart working under load and supplied with blood by the coronary circulation. Under these conditions intracellular recording is taxing, imprecise, and confined to the epicardial surface. Nonetheless, early recordings during acute ischemia confirmed the idea that ischemia caused a decrease in amplitude of the resting potential and abbreviation of the action potential [1, 2].


Coronary Occlusion Purkinje Fiber Normal Zone Ischemic Cell Ischemic Zone 
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© Springer Science+Business Media Dordrecht 1984

Authors and Affiliations

  • Ralph Lazzara
  • Benjamin J. Scherlag

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