Kulbertus H, Collignon P, Humblet L
Br Heart J. 1970 May;32(3):386-92. doi: 10.1136/hrt.32.3.386.
Thirty-four elderly patients with right bundle-branch block and left axis deviation were studied vectorcardiographically utilizing the McFee-Parungao system. Atherosclerosis, arterial hypertension, angina pectoris, cardiac enlargement, and heart failure were common clinical features in this series. Moreover, intermittent advanced degree of atrioventricular block was present in 10 out of the 34 patients. The vectorcardiograms might be readily classified into two basic patterns, types A and B. In type A (19 cases), the frontal plane loop was open-faced. The initial vectors were directed anteriorly, inferiorly, and to the right. The mid-temporal vectors were located in the left postero-superior octant, and the late portion of the loop was inscribed anteriorly to the right with conspicuous conduction delay. Those vectorcardiographic features associate the characteristic patterns of left superior intraventricular block with complete right bundle-branch block. The type B vectorcardiograms (15 cases) demonstrated anterior clockwise loops in the horizontal plane and superior counterclockwise loops in the frontal plane. From a review of the published reports and from personal data, the authors assume that both vectorcardiographic patterns may result from an abnormal spread of excitation resulting from bilateral branch conduction disturbances.
利用麦克菲-帕伦高系统对34例患有右束支传导阻滞和左轴偏移的老年患者进行了心电向量图研究。动脉粥样硬化、动脉高血压、心绞痛、心脏扩大和心力衰竭是该组患者常见的临床特征。此外，34例患者中有10例存在间歇性高度房室传导阻滞。心电向量图可很容易地分为两种基本类型，即A型和B型。在A型（19例）中，额面环是开放型的。初始向量向前、向下并向右。颞中向量位于左后上象限，环的后期部分向右前方记录，伴有明显的传导延迟。这些心电向量图特征将左上室内传导阻滞的特征模式与完全性右束支传导阻滞联系起来。B型心电向量图（15例）在水平面显示顺时针前向环，在额面显示逆时针上向环。通过回顾已发表的报告和个人资料，作者认为这两种心电向量图模式可能均由双侧分支传导障碍导致的异常兴奋传播所致。
