Sohi G S, Flowers N C
Circulation. 1979 Dec;60(6):1354-9. doi: 10.1161/01.cir.60.6.1354.
Total body surface maps obtained from 19 patients with previous inferior myocardial infarction (IMI) were compared with maps obtained from 19 patients with left anterior fascicular block (LAFB) and six more patients in whom electrocardiographic changes were indistinguishable between IMI and LAFB. Three distinguishing features were detected: 1) abnormal high anterior positivity developed both in IMI and LAFB, but its onset was earlier in LAFB; 2) a broad rim of abnormal right lower negativity was seen in both groups, but in IMI it was within the first 40 msec, whereas in LAFB it was found in the middle and later parts of depolarization; 3) abnormal left lower negativity was seen in all the patients with LAFB, but was absent in IMI. Thus, despite similarities in the abnormalities detected, we found definite temporal and topographical differences that should aid in differentiating between IMI and LAFB in ambiguous cases.
将19例既往有下壁心肌梗死（IMI）患者的全身体表心电图图与19例左前分支阻滞（LAFB）患者以及另外6例心电图变化在IMI和LAFB之间难以区分的患者的心电图图进行了比较。检测到三个显著特征：1）IMI和LAFB均出现异常高前壁阳性，但LAFB中其出现更早；2）两组均可见右下腹异常阴性的宽边缘，但在IMI中出现在最初40毫秒内，而在LAFB中出现在去极化的中晚期；3）所有LAFB患者均可见左下异常阴性，但IMI患者中未出现。因此，尽管检测到的异常有相似之处，但我们发现了明确的时间和地形差异，这有助于在疑难病例中区分IMI和LAFB。
