Acute transmural &hernia is expressed on the surface ECG as ST segment elevation. Underlying electrophysio-logical changes include depolarization of the resting mem-brane potential and shortening of the action potential in the ischemic area [l]. The differences between ischemic and non-ischemic cells create extracellular current which causes the potential differences in the extracellular space leading to changes in the electrocardiogram on the epicardial surface (Fig. 1). In the (isolated) pig heart it has been suggested that particularly current flow parallel to the epicardial surface (i.e. between adjacent side-by-side is-chemic and non-ischemic areas) accounts for the observed ECG changes [I]. On the other hand, it is also well known that electrophysiological changes evoked by ischemia (or ischemic components) are more pronounced in epicardia
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