Information on Heart Repolarization Changes Obtained from Body Surface ECG Potentials

Possibility to obtain information about local changes of heart repolarization from body surface potentials was studied on a model. Activation-recovery intervals (ARI) in surface ECG leads were tested as indicators of changed repolarization in the underlying myocardium. ECG signals corresponding to activation of myocardium with normal and changed action potential duration were simulated on the surface of a realistic inhomogeneous torso. ARI intervals were derived from all ECG signals and displayed as surface ARI maps. Results suggest that shortening and prolongation of action potentials in anterior myocardial regions can be visible in corresponding areas on surface ARI maps while only prolongation in postero-lateral regions can be observed. Reproducibility of ARI maps was checked on real measurements using 63 and 192 surface ECG leads. Obtained ARI maps exhibited acceptable reproducibility with correlation of 0.73 to 0.87. Based on the model and experimental results it is hoped that ARI maps can give some insight into the myocardium repolarization and help to recognize tissue with changed properties, primarily in heart regions underlying the anterior chest.