Relationship between the Electrocardiogram and the Position of the Heart as Determined by Biplane Angiocardiography

Guntheroth, Warren G.; Ovenfors, Carl-Olof; Ikkos, D

doi:10.1161/01.cir.23.1.69

Cited by 12 publications

(4 citation statements)

References 10 publications

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“…Grant (1958) in comparing electrical axes with anatomical axes of the heart found that the anatomical position of the heart may account for relatively minor variations in the direction of the mean QRS vector (up to 300) but that it is rarely the cause of the greater axis deviations often seen. Guntheroth, Ovenfors, and Ikkos (1961), however, found no significant correlation between the electrical and anatomical axes in the frontal plane. Beheyt et al (1959) compared axes with height and found no significant correlation.…”

Section: Resultsmentioning

confidence: 67%

Influence of Age, Sex, and Body Habitus on the Mean QRS Electrical Axis in Childhood and Adolescence

Wershing¹,

Walker²

1963

Heart

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The "mean QRS electrical axis" has been defined by Ziegler (1951) as the average direction in which the excitatory process spreads throughout the ventricular myocardium. This mean axis or vector in the frontal plane may be calculated from the standard limb leads and used as an index of cardiac abnormality. In biometrics the term "deviation" is usually used to indicate the departure of a measurement from an established normal value. Thus in electrocardiography right or left axis deviation denotes departure of the electrical forces from the normal toward one or other side of the body. Accurate interpretation of such deviation is dependent upon well-established normal standards, and several authorities (Johnston, 1961;Ezra, 1961;Milnor, 1962) Ashman, 1937;Epstein, 1948;Gros, Gordon, and Miller, 1951;Yu, Joos, and Katsampes, 1951;Veasy and Adams, 1952; Sodi-Pallares et al., 1958a), and many have contained relatively few cases in later childhood and adolescence. Ziegler (1951) considered that his own data on the mean QRS axis merely acted as a "satisfactory nucleus for further study and revision."This investigation, which is part of a larger study of electrocardiograms in normal children and adolescents (Walker and Rose, 1961; Walker and Wershing, in preparation) was thus designed to test statistically the hypotheses of previous writers and to present normal standards related to age, sex, and body habitus from an adequate number of subjects between the ages of 6 months and 20 years. SUBJECTS AND METHODSThe records of 2082 patients who attended the Denver Rheumatic Fever Diagnostic Service during the years 1957 to 1961 were reviewed. Despite the special nature of this clinic, a complete history was taken and a thorough physical examination performed, each patient being examined by two or more experienced piediatric cardiologists on the medical centre faculty. Laboratory studies included urine examination, himatocrit, white blood cell count, differential count, sedimentation rate (Wintrobe), C-reactive protein, and serum mucoprotein tyrosine. A 14-lead electrocardiogram (standard 12 leads plus V3R and V7) was recorded on a standard direct writing Cambridge instrument at 25 mm./sec. paper speed, with a calibration of 1 mV= 10 mm. The majority of the earlier patients had either cardiac fluoroscopy or routine radiograms with barium swallow. More recently, if the history was negative and the murmur typically innocent, this examination was omitted in order to avoid unnecessary radiation. As a result of the evaluation of the 2082 case records, 1199 patients were excluded for one of the following reasons: the history or presence of recent illness (as evidenced by physical findings, raised sedimentation rate, white blood count, or abnormalities in the urine), diagnosis or suspicion of rheumatic fever (past or present), the diagnosis of congenital or acquired organic heart disease or the suspicion of such abnormality. The remaining 883 patients were thus regarded as being normal and were included in this study.

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Section: Resultsmentioning

confidence: 67%

Influence of Age, Sex, and Body Habitus on the Mean QRS Electrical Axis in Childhood and Adolescence

Wershing¹,

Walker²

1963

Heart

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“…However, attempts to assess rotation in coronal and sagittal planes by correlation of the anatomical axis of the heart, obtained from anterior and lateral radiographs of the chest, with the electrical axis (Hyman, Failey, and Ashman, 1948;Fowler and Braunstein, 1951), are clearly subject to considerable error, since there is no way of locating the interventricular septum. Grant (1953), in a series of careful anatomical studies, found little correlation between the electrical (mean QRS) and anatomical axes, and Guntheroth, Ovenfors, and Ikkos (1961) reached similar conclusions as a result of biplane angiocardiographic studies in children.…”

mentioning

confidence: 67%

The electrocardiogram in chronic bronchitis and emphysema.

Chappell¹

1966

Heart

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“…The type II vectorcardiogram might also be explained by anatomical rotation of the heart about a longitudinal axis. The very limited evidence suggests that anatomical rotation of the heart in generalized lung disease or heart disease is insignificant and unrelated to changes in the electrical axis (Grant, 1953;Guntheroth, Ovenfors, and Ikkos, 1961). The type II vectorcardiogram could be related to hyperinflation of the lungs, a mechanism used by Caird and Wilcken (1962) to explain the change in the P axis in the frontal plane, but in the 11 patients who had a type II vectorcardiogram, the P axis exceeded 800 in only 2.…”

Section: Discussionmentioning

confidence: 99%

Electrocardiography amd vectorcardiography in right ventricular hypertrophy from chronic bronchitis.

Brown¹

1968

Heart

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Relationship between the Electrocardiogram and the Position of the Heart as Determined by Biplane Angiocardiography

Cited by 12 publications

References 10 publications

Influence of Age, Sex, and Body Habitus on the Mean QRS Electrical Axis in Childhood and Adolescence

Influence of Age, Sex, and Body Habitus on the Mean QRS Electrical Axis in Childhood and Adolescence

The electrocardiogram in chronic bronchitis and emphysema.

Electrocardiography amd vectorcardiography in right ventricular hypertrophy from chronic bronchitis.

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