PubMed · 759013
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E Krongrad. 1979. "Trifascicular block".. https://doi.org/10.1161/01.cir.59.2.420
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The presentation of the frontal leads was altered so that they could be displayed in sequential angular order. This was achieved by insertion of an inverting switch at the output stage of an electrocardiograph, so that the presented sequence of leads would be I, -aVR, II, aVF, III, and -aVL, corresponding to frontal plane vectors of 0 degree, 30 degrees, 60 degrees, 90 degrees, 120 degrees and 150 degrees. This form of presentation was made in normals, patients with myocardial infarction, hemiblock, and switched leads. A smooth flow of ECG information results, the extent of the disease is more easily evaluated, and the QRS, T, and P axis is more easily evaluated. The usefulness of neglected leads in diagnosis may be increased.
A 53-year-old patient with corrected transposition of the great arteries developed complete heart block with fainting episodes. After temporary pacing through the endocardium of the venous (anatomically left) ventricle, a permanent epicardial pacemaker was implanted. This case shows the progressive nature of the atrioventricular conduction disturbances, which are very common in association with this congenital cardiac anomaly.