On the theory of the electrocardiogram

The biophysical basis for understanding the electrocardiogram is set forth. Bioelectric sources arise from electrical activity in the heart at the cellular level. The relation of these sources, which can be formally represented as impressed currents, to potentials involves solution of the volume conductor problem. This solution is based on Green´s theorem. Sources are related to the transmembrane action potential through a bidomain model of heart muscle. Microscopic and macroscopic aspects of the bidomain model are developed. Various transformations of the source are considered, including multipoles, multiple dipoles, and replacement of the volume distribution with distributions on the heart surface. Time integrals of the waveform are related to excitation time and action potential duration. The theoretical results form the basis of a computer model of the electrocardiogram that relates skin potentials to the spatial and temporal distribution of action potentials in the heart