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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.
1 Hyperkalemia-Suspect as the cause of T wave peaking when the clinical setting is one likely to produce hyperkalemia (ie, renal failure, volume depletion, acidosis, potassium-retaining drugs) â and â when T waves are tall, pointed with steep ascent and near equally steep descent with a narrow base (as seen in Figure 2). However, the most remarkable finding are the very tall, peaked T waves with narrow base (Eiffel Tower effect) in several precordial leads (Figure 2). 2  This strongly suggests Hyperkalemia.