Simulated ST segment potentials generated in single and multivessel coronary artery disease

An accurate computer thorax model was devised to obtain ST segment body surface potentials and 12-lead ECG generated by regionally localized myocardial ischemia. The capability of the leads to detect the location and area of ischemia was appraised. The results agree with clinical knowledge of ischemia detection; limb lead I indicated lateral sources and leads V4 and V5 were generally the best in indicating the sources by ST depression. The 1 mm ST depression criteria was suitable for leads V4 and V5, other leads may need different criteria. ST segment deviation was not directly related to the extent of ischemia or area of the boundary between the healthy and ischemic myocardium.