Lead Systems

Macfarlane, Peter W.

doi:10.1007/978-1-84882-046-3_11

Cited by 11 publications

(9 citation statements)

References 70 publications

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“…Nilsson et al 20 recently reported that a commercially available electrocardiograph could detect 38% of the limb lead reversals in 53 875 ECGs. Most rule‐based models detect only RA‐LA electrode reversal 21 , 22 and cannot identify other combinations of interchange 9 , 12 ; in our study the electrocardiograph identified RA‐LA interchange in only 57.1% of cases. These automated algorithms are also programmed to diagnose other ECG abnormalities, and in the presence of limb interchange, they may make incorrect diagnoses like ectopic atrial rhythm, accelerated junctional rhythm, 23 intraventricular conduction disturbance, 24 , 25 chamber enlargement, ventricular preexcitation, 26 and myocardial ischemia/infarction 27 – 30 in an essentially normal ECG.…”

Section: Discussioncontrasting

confidence: 66%

Limb Lead Interchange in Thorough QT/QTc Studies

Salvi¹,

Karnad²,

Panicker³

et al. 2011

The Journal of Clinical Pharmacology

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The investigators analyzed 85,133 electrocardiograms (ECGs) recorded in 484 subjects from 5 thorough QT/QTc studies (3 using Holter devices, 2 using 12-lead ECGs) for inadvertent limb lead interchanges using a dedicated quality control process in a central ECG laboratory. Limb lead interchanges were present in 2919 (3.4%) ECGs in 17.9% of subjects and were more frequent with Holter devices (7.5% vs 0.8%, P < .0001), where leads remain connected for prolonged periods, affecting data from several time points. Left arm-left leg interchange was seen in 54% of 12-lead ECGs and right arm-left arm interchange in 38%. The ECG device itself could identify 21.7% of interchanges, whereas experienced readers blinded to subject and visit identified 79% of interchanges; 21% of interchanges were identified only during the quality control process. If correctly identified, QT measurement could be performed in a precordial lead. If undiagnosed, incorrect QT interval measurements and morphological diagnosis may confound results.

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Section: Discussioncontrasting

confidence: 66%

Limb Lead Interchange in Thorough QT/QTc Studies

Salvi¹,

Karnad²,

Panicker³

et al. 2011

The Journal of Clinical Pharmacology

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“…A Cartesian coordinate system was used with the positive X-axis pointed towards the left, the positive Y-axis pointed caudally, and the positive Z-axis pointed posteriorly [13].…”

Section: Methods Populationmentioning

confidence: 99%

Spatial QRS-T angle variants for prediction of all-cause mortality

Kück

Isaksen

Graff

et al. 2018

Journal of Electrocardiology

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“…In the absence of traditionally used Frank's orthogonal leads (X, Y, and Z) [4] or a hybrid lead system based on Frank's image space [16] in a resource poor setting, we used leads I, aVF and V2 as a reasonably close approximation to orthogonal leads.…”

Section: Methodsmentioning

confidence: 99%

An evaluation of planarity of the spatial QRS loop by three dimensional vectorcardiography: Its emergence and loss

Ray

Hazra

Goswami³

et al. 2017

Journal of Electrocardiology

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AimsTo objectively characterize and mathematically justify the observation that vectorcardiographic QRS loops in normal individuals are more planar than those from patients with ST elevation myocardial infarction (STEMI). MethodsVectorcardiograms (VCG) were constructed from three simultaneously recorded quasiorthogonal leads, I, aVF and V2 (sampled at 1000 samples/sec). The planarity of these QRS loops was determined by fitting a surface to each loop. Goodness of fit was expressed in numerical terms. Results15 healthy individuals aged 35 -65 years (73% male) and 15 patients aged 45 -70 years (80% male) with diagnosed acute STEMI were recruited. The spatial-QRS loop was found to lie in a plane in normal controls. In STEMI patients, this planarity was lost. Calculation of goodness of fit supported these visual observations. ConclusionsThe degree of planarity of the VCG loop can differentiate healthy individuals from patients with STEMI. This observation is compatible with our basic understanding of the electrophysiology of the human heart.

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Lead Systems

Cited by 11 publications

References 70 publications

Limb Lead Interchange in Thorough QT/QTc Studies

Limb Lead Interchange in Thorough QT/QTc Studies

Spatial QRS-T angle variants for prediction of all-cause mortality

An evaluation of planarity of the spatial QRS loop by three dimensional vectorcardiography: Its emergence and loss

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