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PubMed1987

[Clinical vectorcardiography: the Fritz-Schellong commemorative lecture].

The continuous and direct registration of the vectorcardiogram was realized by cathode-ray oscillographic methods by F. Schellong in 1937 and hence introduced into clinical diagnostics. The following development of different lead systems resulted in the standardization of the corrected orthogonal Frank system, which yielded almost identical information when compared to the Schellong system. The advantages of this continuous registration of the 3-dimensional course of depolarization concern the detection of atrial and ventricular hypertrophy, because the sensitivity, as well as the specificity, of the vectorcardiogram are superior to the ECG. Possibilities of diagnosing myocardial infarction are considerably improved with regard to sensitivity, especially of scars with dorsal and inferior localization, as well as multiple events and simultaneous disturbances of fascicular and ventricular conduction. In addition, even multiple and small defects e.g. in cardiomyopathy or myocarditis, can be detected.

Arrhythmias, Cardiac↗
PubMed1985

Myocardial infarction diagnosis with body surface potential mapping, electrocardiography, vectorcardiography and thallium-201 scintigraphy: a correlative study with left ventriculography.

In 35 subjects with typical or atypical angina and/or documented myocardial infarction (MI), body surface potential maps (BSPMs), ECG, VCG and rest Thallium-201 (T1-201) have been compared to left ventriculography (LVG). BSPMs were recorded with 26 ECGs, and BSPM abnormalities for MI cases were considered to be areas of normally positive potentials that have become negative. Subjects with MI were classified according to the segmental localization and degree of asynergy on LVG. Moderate anterolateral and apical asynergy were found to correlate with BSPM diagnosis of anterolateral MI and ischemia, severe anterolateral and apical asynergy with BSPM diagnosis of anterolateral MI and ischemia, and moderate diaphragmatic and/or posterobasal asynergy with BSPM diagnosis of posterior MI. Simultaneous anterior and posterior asynergy were found for BSPM diagnosis of anterior with posterior MI. Subjects with no LVG asynergy had normal BSPMs. BSPM diagnosis had the highest correlation coefficient with the LVG diagnosis (r = 0.88). ECG and VCG showed similar results with r = 0.65 and 0.71 respectively, while T1-201 had r = 0.55. The examination of our BSPMs, as well as the ECG, VCG and T1-201, did not permit to detect apical damage in presence of anterior MI, and posterobasal damage in the presence of inferoposterior MI. It is concluded that BSPMs are slightly superior to ECG and VCG for diagnosis of MI.

Adult↗
PubMed1977

[Diagnosis of posterior infarction. Value of vectorcardiography. Apropos of 108 cases, 31 of which had exclusively posterior necrosis].

An analysis of the vectorcardiogram results (VCG) in 77 cases with a posterior extension of an infarct and 31 cases with an exclusively posterior infarction (EPI) has allowed us to distinguish some diagnostic criteria relative to the extension, or localisation, of an infarct in the posterior segment. The maximum anterior vector (MAV) appears late (36.5 ms +/- 5), and the amplitude of its projection onto Z is increased; the maximum vector (V max) appears early (41.5 ms +/- 4.5), and its orientation is anterior (+ 24 degrees +/- 11); the interval separating MAV from V max is reduced to 5 ms; the transition from before backwards is late (50 ms +/- 6); the ratio of anterior surface to posterior surface is increased (1.45); there is a terminal delay, most frequently occuring in the right posterior quadrant in 78 percent of cases; and finally, the T loop approaches the Z axis. Repeat electrocardiograms in patients with EPI show the most frequent changes to be represented (in 25 cases out of 31) by the following formula: AQRS " 0 degrees, R/S greater than or equal to 1 in V2, RV2 greater than RV6. The diagnosis of an exclusively posterior infarction can therefore be made with a high degree of certainty when these electrocardiographic abnormalities are associated with the clinical picture of coronary insufficiency.

Computers↗