Chinitz Jason S, Cooper Joshua M, Verdino Ralph J
University of Pennsylvania School of Medicine, Philadelphia, PA, USA.
J Electrocardiol. 2008 Jul-Aug;41(4):281-6. doi: 10.1016/j.jelectrocard.2007.12.001. Epub 2008 Mar 19.
Low voltage on the surface electrocardiogram (ECG) is defined as QRS voltage less than 5 mm in all limb leads and less than 10 mm in all precordial leads. The clinical correlate of an ECG with low voltage in the limb leads but normal precordial QRS amplitudes is unclear.
Twelve-lead ECGs with QRS voltage less than 5 mm in all limb leads and more than 10 mm in at least 2 contiguous precordial leads were collected. Presence of clinical conditions associated with low voltage was determined from clinical data and chest imaging.
Fifty-one of 100 patients had voltage discordant ECGs that correlated with conditions known to cause diffuse low voltage. Among those without associated conditions, 63% had dilated ventricles, with an average ejection fraction of 33%.
Low voltage isolated to the limb leads is associated with the same conditions that cause diffuse low voltage in only half of patients. In the remainder, more than 60% have dilated cardiomyopathies.
体表心电图（ECG）低电压定义为所有肢体导联QRS电压小于5mm且所有胸前导联QRS电压小于10mm。肢体导联低电压但胸前QRS波幅正常的心电图的临床关联尚不清楚。
收集所有肢体导联QRS电压小于5mm且至少2个相邻胸前导联QRS电压大于10mm的十二导联心电图。根据临床资料和胸部影像学检查确定与低电压相关的临床情况。
100例患者中有51例心电图电压不一致，与已知导致弥漫性低电压的情况相关。在无相关情况的患者中，63%有心室扩大，平均射血分数为33%。
仅肢体导联出现的低电压在仅一半的患者中与导致弥漫性低电压的情况相关。在其余患者中，超过60%患有扩张型心肌病。
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