Berson A S, Haisty W K, Pipberger H V
Am Heart J. 1978 Apr;95(4):463-73. doi: 10.1016/0002-8703(78)90238-7.
Frank lead electrocardiograms were recorded from 149 normal and abnormal adult males using four different electrode placements. All chest electrodes were placed at: (1) the fourth intercostal space level, (2) the fifth intercostal space level, (3) the fourth intercostal space level with V4 substituted for C, and (4) the fifth intercostal space level with V4 substituted for C. Differences in mean values of many commonly used amplitudes and orientations were not statistically significant among the four recording methods, but amplitude differences for individual subjects were often large and difficult to predict. When V4 is substituted for C, as commonly done in some laboratories, Rx decreased and Rz increased by more than 10 per cent in about 40 per cent of the cases. In about 70 per cent of the cases, Rx and Rz changed significantly when electrode level was shifted from the fifth to the fourth intercostal space. For these 70 per cent, it does not appear possible to accurately predict increase or decrease of Rx, Rz, or QRSm. Analysis programs which depend on individual amplitude measurements are likely to be significantly affected by electrode placement. It is suggested that criteria for analysis programs developed using a specified version of the Frank system should ideally be applied only to electrocardiograms recorded in the same manner.
使用四种不同的电极放置方式，对149名正常和异常成年男性进行了Frank导联心电图记录。所有胸部电极均放置在：(1) 第四肋间水平，(2) 第五肋间水平，(3) 第四肋间水平且用V4代替C，以及(4) 第五肋间水平且用V4代替C。四种记录方法之间许多常用振幅和方向的平均值差异无统计学意义，但个体受试者的振幅差异通常很大且难以预测。当像一些实验室通常所做的那样用V4代替C时，约40%的病例中Rx降低且Rz升高超过10%。在约70%的病例中，当电极水平从第五肋间移至第四肋间时，Rx和Rz发生显著变化。对于这70%的病例，似乎无法准确预测Rx、Rz或QRSm的升高或降低。依赖个体振幅测量的分析程序可能会受到电极放置的显著影响。建议使用特定版本Frank系统开发的分析程序标准理想情况下仅应用于以相同方式记录的心电图。
