Diagnostic usefulness of activation-recovery interval for reciprocal ECG changes

The proximal left circumflex coronary artery (LCx) was cannulated and perfused with blood from the carotid artery in nine open-chest dogs. Perfused blood temperature was modulated by immersing a bypass tube in a temperature-controlled water tank. Two epicardial electrodes were placed, one at the LCx area and one at the left anterior descending coronary artery (LAD) area. The temperature of the autoperfused blood was set at 23°C and was gradually elevated to 42°C during 30 minutes. The QRS, ST-T, and QRST areas, and the activation-recovery interval of the electrode at the LCx area, changed unidirectionally in relation to elevation of the blood temperature. Although the QRS, ST-T, and QRST areas of the electrode at the LAD area changed in proportion to changes in the electrode at the LCx area, the activation-recovery interval of the electrode at the LAD area remained constant in all dogs. During 2-minute occlusion of the proximal LCx (n=7), the activation-recovery interval of the electrode at the LAD area also remained constant despite the presence of reciprocal electrocardiographic changes. The activation-recovery interval is a useful index for defining whether a change in ST-T in a unipolar electrogram is due to a local electrophysiologic effect or a reciprocal effect.