Document Detail

Optimal electrocardiographic limb lead set for rapid emphysema screening.
MedLine Citation:
PMID:  23378754     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Pulmonary emphysema of any etiology has been shown to be strongly and quasidiagnostically associated with a vertical frontal P wave axis. A vertical P wave axis (>60 degrees) during sinus rhythm can be easily determined by a P wave in lead III greater than the P wave in lead I (bipolar lead set) or a dominantly negative P wave in aVL (unipolar lead set). The purpose of this investigation was to determine which set of limb leads may be better for identifying the vertical P vector of emphysema in adults.
METHODS: Unselected consecutive electrocardiograms from 100 patients with a diagnosis of emphysema were analyzed to determine the P wave axis. Patients aged younger than 45 years, those not in sinus rhythm, and those with poor quality tracings were excluded. The electrocardiographic data were divided into three categories depending on the frontal P wave axis, ie, >60 degrees, 60 degrees, or <60 degrees, by each criterion (P amplitude lead III > lead I and a negative P wave in aVL).
RESULTS: Sixty-six percent of patients had a P wave axis > 60 degrees based on aVL, and 88% of patients had a P wave axis > 60 degrees based on the P wave in lead III being greater than in lead I.
CONCLUSION: A P wave in lead III greater than that in lead I is a more sensitive marker than a negative P wave in aVL for diagnosing emphysema and is recommended for rapid routine screening.
Rishi Bajaj; Lovely Chhabra; Zainab Basheer; David H Spodick
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Publication Detail:
Type:  Journal Article     Date:  2013-01-19
Journal Detail:
Title:  International journal of chronic obstructive pulmonary disease     Volume:  8     ISSN:  1178-2005     ISO Abbreviation:  Int J Chron Obstruct Pulmon Dis     Publication Date:  2013  
Date Detail:
Created Date:  2013-02-04     Completed Date:  2013-06-14     Revised Date:  2013-07-11    
Medline Journal Info:
Nlm Unique ID:  101273481     Medline TA:  Int J Chron Obstruct Pulmon Dis     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  41-4     Citation Subset:  IM    
Department of Internal Medicine, University of Massachusetts Medical School, Worcester, MA 01604, USA.
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MeSH Terms
Mass Screening
Pulmonary Emphysema / diagnosis*
Smoking / epidemiology

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