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PubMed1982

Octant vectorcardiography - the evaluation by peaks.

From the Frank lead potentials a computer prints out an elementary table. Therein, the electrical space of left ventricle depolarization is divided into eight spatial parts labelled by numbers 1-8 and called octants. Within these octants six peaks are determined labelled with letters ALPR-IS. Their localization is described by six-digit topograms characteristic for each patient. From 300 cases of patients after myocardial infarction, three data bases were compiled enabling every case to be classified into classes, subclasses and types. The follow up of patients according to these principles gives an objective and detailed image about the progress of coronary artery disease.

Computers↗
PubMedDate not supplied

[Vectorcardiography in infarction of the right ventricle].

A vectorcardiogram (VCG) was recorded in 22 patients in the acute phase of a right ventricular infarct in order to investigate any characteristic signs of this diagnosis. The RV infarct had been proven by at least two investigations: 2D echo, isotopes and right ventricular catheterisation. 17 patients had ST depression in V4R. The QRS complex presented two features: there was a reduced refractory period in every case, associated with septal extension in 3 cases and true posterior infarction in 11 cases, and, in the frontal plane, the QRS which was in clockwise rotation had showed an abnormal left axial lead in 18 cases with a maximal vectorial axis of between - 10 degrees and - 60 degrees. These modifications are similar to those seen in experimental infarcts of the RV. In conclusion, repeated VCGs in the acute phase of inferior infarction should suggest the diagnosis of right ventricular extension if it shows the appearance of more marked left axis deviation than that seen with isolated inferior infarcts. However, this sign is no constant and is not specific.

Adult↗
PubMedDate not supplied

[Vectorcardiography in the diagnosis of the association of inferior necrosis--left intraventricular conduction disorders].

The authors study 53 vectorcardiograms (VCG) which demonstrate the association of inferior myocardial necrosis with left intraventricular conduction disturbances (LIVCD) consisting of 44 left anterior hemi-blocks (LAHB), 2 left posterior hemi-blocks (LPHB) and 7 complete left branch blocks (CLBB). In the presence of LAHB, the ECG and VCG diagnosis concur in 37 cases, with a more obvious appearance on the VCG in 16 cases. In 7 cases, only the VCG provided the diagnosis of this association. In the presence of LPHB, the ECG, in one case, only showed signs of necrosis and only the VCG revealed the hemi-block; in the other case, the ECG showed signs of LPHB, but the Q waves did not present the criteria of necrosis. Once again, only the VCG provided the diagnosis of the association. Finally, in the presence of CLBB, the diagnosis were in agreement in only 3 cases. In two cases, only the VCG revealed the necrosis, in one case, the ECG was superior and in the remaining case, the ECG and the VCG were equally ineffective in confirming the inferior necrosis which was nevertheless definitely present. On the basis of these findings, the authors discuss the ECG criteria of the association of inferior necrosis and LIVCD.

Cardiomyopathies↗
PubMed1982

[Posterobasal infarction and right bundle branch block: value of computerized vectorcardiography].

The object of this study was to determine the vectocardiographic criteria of posterobasal myocardial infarction associated with right bundle branch block. Seventeen patients were examined; all had clinical and enzymatic evidence of myocardial infarction, associated with the unusual appearances of right bundle branch block with an isolated R wave in V1 and V2. The Frank X, Y, and Z axes were treated by computer to obtain a detailed octonal study of the QRS and T loops. Vectors of special interest were determined: the maximum maximorum vector and the QRS half surface vector (module, azimuth, elevation, appearance time). The octonal and total surface are of the QRS and T loops and the spatial angle of the maximal vectors of the two loops were calculated. These cases were characterised by clockwise rotation of the QRS loop in the horizontal plane. The maximal QRS vector had a decrease module (1,29 mV +/- 0,49), an azimuth greater than 20 degrees (42,8 degree +2- 20,3) an appearance time of 55,7 +/- 12,1, and an elevation which was either positive or negative depending on the presence or absence of an associated left anterior hemiblock. The half-surface vector was superimposed on the maximal vector: module (1,09 mV +/- 0,39), azimuth (45,2 degrees 23,5(and appearance time (62,0 +/- 11,7 ms). The posterior surfaces were nil or negligible (less than 1 p. 100). The T loop had a clockwise rotation in the horizontal plane and its maximal vector projected anteriorly in 8 patients. The appearances observed in these 17 cases were different to those of isolated right bundle branch block. The classical causes of anterior ORS loops could be excluded easily: right ventricular hypertrophy, Wolff-Parkinson-White syndrome, intraventricular conduction defect. The following criteria were retained in the diagnosis of posterobasal infarction associated with right bundle branch block:--principally, clockwise rotation of the QRS loop in the horizontal plane;--anterior displacement of the maximal vector with an azimuth of over 20 degrees;--disappearance of the posterior forces;--associated with the usual criteria of right bundle branch block;--clockwise rotation of the T wave loop in the horizontal plane.

Bundle-Branch Block↗
PubMed1982

Electrocardiography vs. vectorcardiography in the diagnosis of left anterior hemiblock associated with inferior wall myocardial infarction: a critical analysis.

The ECG criteria of isolated left anterior hemiblock (LAHB) are well established. However, associated inferior wall myocardial infarction (IMI) can obscure the ECG characteristics of LAHB. In an attempt to evaluate various ECG signs of LAHB in the presence of IMI, three groups of patients were examined. Group I comprised 20 patients with unequivocal vectorcardiographic (VCG) signs of isolated LAHB; Group II included 30 patients with VCG-documented IMI; and the 20 patients in Group III had VCG evidence of IMI with LAHB. Four ECG criteria were evaluated and their average performances in the diagnosis of LAHB were determined. QRS axis above -30 degrees, the presence of terminal S wave in lead II and terminal R wave in lead AVR and delayed intrinsicoid deflection in lead AVL showed average performances of 86.2, 76.7, 68.7 and 60.8% respectively. The ECG criteria in the diagnosis of LAHB are highly sensitive but do not reach the high specificity claimed by other authors.

Adult↗
PubMed1982

[Value of vectorcardiography in the diagnosis of postero-septal infarct].

Posteroinferior infarction often complicated by the contemporaneous antero-septal necrosis due to anterior descending coronary artery critical stenosis. To confirm the value of VCG in the diagnosis of these two necrosis as regards ECG, the Authors have studied with echocardiogram, 19 patients with postero infarction, with or without inferior necrosis. The results were: frequent association of antero-septal infarction in postero-inferior necrosis; morphological and chronological VCG criteria in the diagnosis of postero-septal infarct; VCG use as bloodless method, to distinguish among the subjects with postero necrosis, the patients who must be subjected coronary angiography.

Coronary Disease↗