A quantitative estimation of electric current due to myocardial injury

Myocardial injury causes electric current at the border of injured muscle and the surrounding intact region. In order to determine the magnitude of the injury current, experiments were performed with the isolated canine heart perfused with Tyrode's solution. The anterior descending branch of the left coronary artery was perfused selectively with high potassium (K+) solution and the resulting injury current was reflected in the ST shift of the orthogonal electrocardiogram, derived from the surface of a cubic container in which the heart was placed. After measurement of the ST vector with different K+ concentrations, the heart has fixed with formalin and the injury zone was delineated with serial sections. The boundaries of the selectively perfused region were reconstructed. The algebraic sum of orthogonal components of boundary surfaces determined the average direction normal to the boundary, which was found to be parallel with the ST vector. With increasing K+ concentrations, the ST shift became more marked. However, it was saturated at about 30 mEq/L K+. The maximum injury current, calculated from the saturated value of the ST magnitude, amounted to 0.10 mA.cm per unit area of the boundary surface. Additional experiments were performed with right ventricular papillary muscle preparations. Injuries were caused by a cotton pad containing high K+ solution placed in two directions to make the border along and across the long axis of the papillary muscle. The results indicate that the injury current in an anisotropic structure was essentially directed along the fiber orientation.