Document Detail

Fundamental differences between the standard 12-lead electrocardiograph and the modified (Mason-Likar) exercise lead system.
MedLine Citation:
PMID:  3653124     Owner:  NLM     Status:  MEDLINE    
A comparison of the standard 12-lead electrocardiograph with the Mason-Likar lead system widely used for exercise stress testing shows that the two are not 'essentially identical' as was originally claimed. Placement of the limb electrodes onto the torso distorts the electrocardiograph causing a rightward shift of the mean QRS axis, a significant reduction in R-wave amplitude in leads I and aVL, and a significant increase in R-wave amplitude in leads II, III and aVF; the R-wave amplitude of the chest leads is also altered. The so-called 'inferior' leads on the exercise electrocardiography are probably modified anterior/inferior leads, since their R-wave amplitudes correlate closely with those of antero-lateral chest leads. The inferior surface of the heart is not represented in isolation on the exercise electrocardiograph, thus explaining the reported inability of the exercise test to predict the location of coronary artery disease and high incidence of false negative tests in patients with ischaemia limited to the inferior cardiac surface.
M Papouchado; P R Walker; M A James; L M Clarke
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European heart journal     Volume:  8     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1987 Jul 
Date Detail:
Created Date:  1987-11-17     Completed Date:  1987-11-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  725-33     Citation Subset:  IM    
Department of Cardiology, Bristol Royal Infirmary, Avon, U.K.
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MeSH Terms
Coronary Disease / diagnosis*
Electrocardiography / methods*,  standards
Exercise Test*
False Negative Reactions

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