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The faster repolarization of the cardiac action potential causes the tenting of the T waves, and the inactivation of sodium channels causes a sluggish conduction of the electrical wave around the heart, which leads to smaller P waves and widening of the QRS complex.
What Causes an Inverted T-Wave? The T wave is the ECG manifestation of ventricular repolarization of the cardiac electrical cycle. The T wave is normally upright in leads I, II, and V3 to V6; inverted in lead aVR; and variable in leads III, aVL, aVF, V1, and V2. Thus, T-wave inversions in leads V1 and V2 may be fully normal.