Comparative Quantitative Analysis of the Electrocardiogram and the Vectorcardiogram Correlations with the Coronary Arteriogram
TL;DR: Quantitative VCG analysis appears superior to the usual ECG analysis in the accurate detection of MI and when MI is diagnosed by either technic, significant associated coronary artery disease can be anticipated in a predictable anatomic distribution.
Abstract: Simultaneously recorded standard electrocardiograms (ECG) and Frank vectorcardiograms (VCG) were correlated with the coronary arteriograms and the left ventriculograms of 210 patients. Quantitative criteria were applied to ECG measurements made by manual technics and to VCG measurements obtained by computer technics. As the extent of significant arteriographic disease increased, the frequency of ECG and VCG evidence of "definite" myocardial infarction (MI) increased. The VCG was diagnostic of MI in a greater number of patients than the ECG (50 versus 39, P < 0.01) and excelled in the detection of multiple areas of infarction in a greater number of patients (13 versus six, P < 0.05). This increased sensitivity was gained in anterior, inferior, and true posterior infarcts. Excluding patients with myocardiopathy, all MIs diagnosed from the VCG and all but one from the ECG were associated with significant arteriographic disease in the distribution of the predicted nutrient artery. Quantitative VCG analysis ap...
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TL;DR: In this article, a cardiac monitoring and telemedicine method and system provides advanced ischemia and infarction analysis and monitoring, and advanced calculations are performed on ECG signals to obtain parameter values relating to myocardial ischeia and Infarction, which is analyzed to determine the parameter values continuously and in real-time.
Abstract: A cardiac monitoring and telemedicine method and system provides advanced ischemia and infarction analysis and monitoring. Advanced calculations are performed on ECG signals to obtain parameter values relating to myocardial ischemia and infarction. Dominant heart beats are averaged to form a smooth beat, which is analyzed to determine the parameter values continuously and in real-time. The device includes an entry portion for input of information data and a communication portion for bi-directional communication with a central unit.
360 citations
TL;DR: This study correlated the location and size of posterolateral myocardial infarcts (MIs) measured anatomically with that estimated by quantitative criteria derived from the standard 12-lead ECG.
Abstract: This study correlated the location and size of posterolateral myocardial infarcts (Mls) measured anatomically with that estimated by quantitative criteria derived from the standard 12-lead ECG. Twenty patients were studied who had autopsy-proved, single, posterolateral Mls and no confounding factors of ventricular hypertrophy or bundle branch block in their ECG. Left ventricular anatomic Ml size ranged from 1 to 46%. No patient had a ≥ 0.04-second Q wave in any electrocardiographic lead and only 55% had a 0.03-second Q wave. A 29-point, simplified QRS scoring system consisting of 37 weighted criteria was applied to the ECG. Points were scored by the ECG in 85% of the patients (range 1 to 8 points). Ml was indicated by a wide variety of QRS criteria; 19 of the 37 criteria from 8 different electrocardiographic leads were met. The correlation coefficient between MI size measured anatomically and that estimated by the QRS score was 0.72. Each point represented approximately 4% Ml of the left ventricular wall.
349 citations
TL;DR: In patients without complicating factors in the electrocardiogram and with a single infarct, the electro Cardiogram provides a marker for infarction in the anterior third of the left ventricle and permits estimation of infarCT size.
Abstract: This study evaluated by quantitative autopsy correlation a previously developed scoring system for estimating the size of myocardial infarcts based on the QRS complex of the electrocardiogram. This system was tested using electrocardiograms from patients with infarcts shown by autopsy to predominate in the inferior third of the left ventricle. The study was limited to patients whose electrocardiogram did not indicate left or right ventricular hypertrophy, left or right bundle branch block, or left anterior or posterior fascicular block. Thirty-one patients from 6 medical centers met these criteria. In the electrocardiogram of 28 of the 31 patients (90%), lead a VF exhibited a Q wave of at least 30 ms. The correlation coefficient between the total QRS score and the percent infarction of the left ventricle was 0.74. In patients without confounding factors in the electrocardiogram and with single infarcts, the electrocardiogram provides a marker for infarcts in the inferior third of the left ventricle and a quantitative QRS scoring system provides an estimate of infarct size.
292 citations
TL;DR: Discriminate function analysis of all admission historical and ECG variables identified inferior and lateral ST elevation as independent predictors of circumflex artery-related infarction and multivessel disease.
187 citations
TL;DR: IMAG's yield higher patency and comparable flow rates to SVG's and should be used when the IMA approximates the recipient artery in size and when a high pulsatile free flow is measured from the end of the graft.
170 citations
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TL;DR: A news improved system of spatial vectorcardiography that is practical for clinical use that represents an optimum compromise among such factors as soundness of theoretic basis, accuracy, reproducibility, signal-to-noise ratio, and speed of application is described.
Abstract: This paper describes a news improved system of spatial vectorcardiography that is practical for clinical use. It represents an optimum compromise among such factors as soundness of theoretic basis, accuracy, reproducibility, signal-to-noise ratio, and speed of application. Some of its advantages over currently employed systems include a rational physical basis, corrections for torso shape, avoidance of left arm, insensitivity to individual variability of ventricle location, and accuracy comparable to applicability of 3-dimensional torso-model data to the human subject. Detailed description of electrode placement, practical procedures, and useful technics is included.
1,053 citations
TL;DR: By COMMITTEE MEMBERS: CHARLES E. KOSSMANN, M.D., CHAIRMAN, DANIEL A. BRODY, MD., GEORGE E. BURCH,M.D, and HUBERT V. PIPBERGER, M,D, of the SUBCOMMITTEE on Instrumentation.
Abstract: By COMMITTEE MEMBERS: CHARLES E. KOSSMANN, M.D., CHAIRMAN, DANIEL A. BRODY, M.D., GEORGE E. BURCH, M.D., HANs H. HECHT, M.D., FRANKLIN D. JOHNSTON, M.D., CALVIN KAY, M.D., EUGENE LEPESCHKIN, M.D., HUBERT V. PIPBERGER, M.D., AND by MEMBERS OF THE SUBCOMMITTEE ON INSTRUMENTATION: * HUBERT V. PIPBERGER, M.D., CHAIRMAN, GERHARD BAULE, PH.D., ALAN S. BERSON, M.S., STANLEY A. BRILLER, M.D., DAVID B. GESELOWITZ, Ph.D., LEO G. HORAN, M.D., AND OTTO H. SCHMITT, Ph.D.
295 citations
158 citations