Abildskov J A
J Electrocardiol. 1976;9(4):345-50. doi: 10.1016/s0022-0736(76)80027-1.
The relations of QRS amplitude sums to activation boundary size at two instants was evaluated in five normal subjects. In each subject, QRS amplitude sums from 192 simultaneously recorded torso electrocardiograms and from 35 leads from the precordial area only were obtained 10 and 15 msec after the QRS onset. Activation boundary size at these instants was taken from published studies of ventricular excitation sequence in the human heart. The relative size of electrocargiographically effective boundaries at 10 and 15 msec and the measured QRS amplitude sum at 10 msec were used to predict expected QRS amplitude sums at 15 msec. Differences between the predicted and measured QRS amplitude sums at 15 msec constitute an estimate of error in determining cardiac source size from its expressions in the body surface electrocardiogram (ECG). Results demonstrated a more consistent relation of activation boundary size to QRS sums from the 192 than from the 35 electrode array. Indirectly the results suggest summed ST segment displacement from the larger array of electrodes would be more consistently related to the extent or severity of myocardial injury than an ST segment displacement sum based on 35 precordial leads. Finally, the findings suggested that the absolute sum of an electrocardiographic measurement such as ST segment displacement would provide a better index of lesion size than ST elevation or depression only.
在五名正常受试者中评估了两个时刻QRS波幅总和与激活边界大小的关系。在每个受试者中，在QRS波起始后10毫秒和15毫秒时，获取了来自192个同步记录的躯干心电图以及仅来自心前区35个导联的QRS波幅总和。这些时刻的激活边界大小取自已发表的关于人类心脏心室兴奋序列的研究。利用10毫秒和15毫秒时心电图有效边界的相对大小以及10毫秒时测量的QRS波幅总和来预测15毫秒时预期的QRS波幅总和。15毫秒时预测的和测量的QRS波幅总和之间的差异构成了从体表心电图（ECG）中其表现来确定心脏源大小的误差估计。结果表明，与来自35电极阵列的情况相比，激活边界大小与来自192个电极的QRS总和之间的关系更一致。间接而言，结果表明，与基于35个心前导联的ST段位移总和相比，来自更大电极阵列的ST段位移总和与心肌损伤的程度或严重性之间的关系更一致。最后，研究结果表明，诸如ST段位移等心电图测量的绝对总和将比仅ST段抬高或压低提供更好的病变大小指标。
