Koechlin R, Leblanc P
C R Acad Sci III. 1986;303(18):723-8.
The heart can take different anatomical orientations in the chest of various subjects and even in the same subject. The corresponding changes in perspective can deeply affect the electrical tracings recorded by fixed standardized leads. One same electrogenesis takes many appearances, complicating the analysis. Anatomically intrinsic tracings can be obtained with O. H. Schmitt's Resolver from a usual X, Y, Z lead system. Its moving trihaedral X'', Y'', Z'', has to be brought onto the heart's axis and septum. Being directly related to the heart, these tracings become independent of the heart's anatomical position in the chest. They show the electrical to anatomical topographic relations. However, they have not been in favour because Clinicians could not relate them to their usual rules of interpretation. This Note describes how to obtain normalized tracings that can benefit from the usual criteria of interpretation, as if shifted hearts were seen in an intermediate position. A constant opposite intermediate shift is applied to the three, X'', Y'', Z'', intrinsic components to restore an arbitrary normalized position. The new X'', Y'', Z'', components follow the moving trihaedral brought on the individual anatomical position measured by X rays and echocardiography. A heart being naturally in an intermediate position gives tracings as if no Resolver was in action. Compensated (or normalized) ECG's or isopotential maps can be similarly computed.
在不同个体甚至同一个体的胸腔中,心脏可呈现不同的解剖方位。视角的相应变化会深刻影响由固定标准化导联记录的电描记图。同一电发生过程会呈现多种表现形式,这使得分析变得复杂。使用O. H. 施密特分解器可从常规的X、Y、Z导联系统获得解剖学上的固有描记图。其移动的三面体X''、Y''、Z''必须与心脏轴和室间隔对齐。这些描记图与心脏直接相关,因而独立于心脏在胸腔中的解剖位置。它们显示了电与解剖的地形关系。然而,它们并不受欢迎,因为临床医生无法将其与常用的解读规则联系起来。本说明描述了如何获得可受益于常用解读标准的标准化描记图,就好像移位的心脏处于中间位置一样。对三个固有分量X''、Y''、Z''施加恒定的相反中间移位,以恢复任意的标准化位置。新的X''、Y''、Z''分量跟随由X射线和超声心动图测量的个体解剖位置上的移动三面体。自然处于中间位置的心脏产生的描记图就好像没有分解器在起作用一样。补偿(或标准化)心电图或等电位图也可类似地计算得出。