Centro Médico Florida, Buenos Aires, Argentina; Lankenau Institute for Medical Research, Wynnewood, PA, USA.
Centro Médico Florida, Buenos Aires, Argentina; Lankenau Institute for Medical Research, Wynnewood, PA, USA.
J Electrocardiol. 2023 Jul-Aug;79:89-96. doi: 10.1016/j.jelectrocard.2023.03.012. Epub 2023 Mar 27.
Precordial Bipolar Leads (PBL) provide new electrocardiographic information derived from standard 12‑lead ECG recordings.
To explore the usefulness of PBL in patients with acute right coronary artery (RCA) occlusion.
Sixteen patients undergoing elective percutaneous transluminal coronary angioplasty (PTCA) were studied before and after RCA occlusion and their data were processed with new methods based on PBL.
The findings were: 1. In PBL V2-V1, strong systolic currents of injury moving in the left to right direction coexist with those directed towards leads II, III and aVF. 2. Changes in the time of the peaks of the QRS waves do not alter the duration of the QRS. 3. The QRS loops of the surrogate VCG generated show that, during ischemia, the time changes in the peak of the QRS waves displayed in one axis are the consequence of an increase in the amplitude of the waves observed in the perpendicular axis. 4. The use of two simultaneous dimensions (transverse and frontal planes) facilitates the location of the J-point. 5. In the surrogate VCGs of this group of patients, J-point and ST segment shifts produced an image that reminded the Greek letter omega (Ω). 6. The QRS wave changes, in time and amplitude, explained the rotational changes and the ischemic distortions of the surrogate VCG loops.
Computerized processing of ECG data appears to provide new and valuable diagnostic data in patients with acute RCA occlusion. The loops revealed important information related to systolic currents of injury. Because these methods use routine 12‑lead ECG data, the procedure is based only in software applications.
心前区双极导联（PBL）提供了源自标准 12 导联心电图记录的新的心电图信息。
探讨 PBL 在急性右冠状动脉（RCA）闭塞患者中的应用价值。
对 16 例行选择性经皮腔内冠状动脉成形术（PTCA）的患者进行研究，分别在 RCA 闭塞前后进行，其数据采用基于 PBL 的新方法进行处理。
研究结果如下：1. 在 PBL V2-V1 导联中，强烈的损伤性收缩电流从左到右方向移动，与指向导联 II、III 和 aVF 的电流共存。2. QRS 波峰时间的变化不会改变 QRS 波的持续时间。3. 生成的替代 VCG 的 QRS 环表明，在缺血期间，一个轴上观察到的 QRS 波峰值的时间变化是垂直轴上观察到的波振幅增加的结果。4. 使用两个同时的维度（横切面和冠状面）有助于定位 J 点。5. 在这群患者的替代 VCG 中，J 点和 ST 段移位产生了一个类似于希腊字母ω（Ω）的图像。6. QRS 波的时间和幅度变化解释了替代 VCG 环的旋转变化和缺血性扭曲。
心电图数据的计算机处理似乎为急性 RCA 闭塞患者提供了新的有价值的诊断数据。环揭示了与损伤性收缩电流相关的重要信息。由于这些方法使用常规的 12 导联心电图数据，该过程仅基于软件应用。
