Document Detail

Precordial leads QRST time integrals for evaluation of right ventricular overload in children with congenital heart diseases.
MedLine Citation:
PMID:  9261734     Owner:  NLM     Status:  MEDLINE    
It was previously shown that body surface QRST isointegral maps of the anterior chest were abnormal in patients with right ventricular overload and that the abnormalities varied with hemodynamic status. The QRST isointegral maps were first characterized by using a departure index map for normal controls. The study group consisted of 14 patients with pulmonary stenosis (PS), 20 with tetralogy of Fallot, (TOF) and 43 with atrial septal defect (ASD). The QRST isointegral maps of these three groups were compared with the data on 23 to 65 age-matched normal children. In mean departure index maps, the patients with right ventricular pressure overload (PS or TOF) showed an increase in departure index on the anterior midchest, while those of right ventricular volume overload (ASD) showed two maxima on the anterior and left lateral chest, with a trough-like negative area between them. Since the abnormal findings were seen on the anterior chest, we evaluated the diagnostic usefulness of QRST time integral values for precordial leads of the routine electrocardiogram (ECG) in a second part of this study. The precordial QRST time integral values from 9 patients with PS and 11 with TOF (0-2 years of age, mean 1.1 years) and 22 ASD patients (6-15 years, mean 10.1 years) were compared with those of the age-matched control children. The QRST time integral values of the precordial leads in right ventricular pressure overload were significantly increased in the right precordial leads (V1, V2). In right ventricular volume overload, the QRST time integral values of the V1, V2, V4, and V6 leads demonstrated a significant deviation from those of the control group. Therefore, a discrimination formula was constructed by using the values of these leads, and the criteria derived from this formula revealed good (98%) diagnostic accuracy. In detection of right ventricular overload, the QRST time integral values of the precordial lead ECG, if confirmed in a larger data set, may be useful as a simple screening method.
N Izumida; Y Asano; K Kiyohara; S Doi; H Wakimoto; S Tsuchiya; J Hosaki; S Kawano; T Sawanobori; M Hiraoka
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  30     ISSN:  0022-0736     ISO Abbreviation:  J Electrocardiol     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-09-22     Completed Date:  1997-09-22     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  257-64     Citation Subset:  IM    
Department of Pediatrics, School of Medicine, Tokyo Medical and Dental University, Japan.
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MeSH Terms
Body Surface Potential Mapping
Child, Preschool
Electrocardiography* / methods
Heart Defects, Congenital / diagnosis*,  physiopathology
Ventricular Dysfunction, Right / diagnosis*,  physiopathology

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