Abstract

Macroscopic recordings of the cardiac electrical field were first obtained empirically in the late 19th century and through the electrocardiogram provided platform technologies allowing clinical cardiology to flourish. Physical first principles dictate that these fields must originate from charge movements across cardiac cell membranes and we now show clinically that charge density calculations precisely locate the sources of the field. Such localization has significantly enhanced treatment efficacy. Furthermore, the charge-based model allows a direct route to integration starting from charge movements in structurally resolved intramembrane channels through Hodgkin-Huxley formalism to body surface recordings. These constructs provide a means to resolve the biology underlying the generation of the cardiac rhythm and design targeted therapeutics.