Hypothermia is known to affect the electrophysiology of the myocardium in various ways. A marked increase in action potential duration, combined with a decrease in rate of depolarization and conduction velocity, has been observed. We studied the effect of localized hypothermia of the ventricular myocardium on the high-frequency (HF) components of the ECG waveform. Signals were obtained from 6 anesthetized dogs using simultaneous recording of three orthogonal body surface leads before, during, and following surface cooling of different areas of the epicardium. Computer analysis included digital averaging and filtering in a frequency range of 150-250 Hz. For each intervention in each animal, the variance of the average nonfiltered QRS complex was used for a quantitative estimate of the total power, whereas the variance of the derived filtered wave (HF QRS complex) expressed the power content in the HF range. The total power increased during localized cooling of the anterior as well as the inferior epicardial surface, while a clear reduction of power was observed in the HF range. This reduction was shown to be lead dependent and nonuniformly distributed during the course of the QRS. In all cases, hypothermia of either anterior or inferior ventricular epicardium produced a zone of reduced amplitude in the HF QRS complex of at least one lead. Thus, typical changes in the morphology of the HF QRS complex are reliable markers for cooling-induced localized electrophysiological (EP) variations. Therefore, the HF analysis of the body surface ECG may provide noninvasive insight into the EP properties of the myocardium.