The corrected orthogonal electrocardiogram in normal children

Gamboa, Raul; White, Nancy R.

doi:10.1016/0002-8703(68)90003-3

Cited by 8 publications

(5 citation statements)

References 32 publications

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“…If T is 3400 and QRS is 20°, then a is 3200. In looking at our population, for example the total group (11)(12)(13)(14)(15)(16)(17)(18)(19) in the Frank system, the "average" deviation & is 42°for the horizontal plane. The relatively high D of .78 indicates that the dispersion is not great, while the high Chisquare indicates that the D can be trusted.…”

Section: Ratios Of Maximal Projectionsmentioning

confidence: 99%

“…With the E for M machine, the vector trace was interrupted both every 0.002 sec for douible loops and 0.001 sec for single loops. 11 15 62 .085 M 16-19 30 .091 M MeFee Lead System (IM) M 11 15 62 .085 M 16 19 30 .091 M 11-19 92 .087 F 11-15 42 .088 F16 19 32 .078 F 11-19 74 .084 T 11-15 104 .087 T 16 The dots of each QRS were numbered and the X, Y and Z components measured and entered on computer sheets. The T wave was analyzed only for the maximal planar and spatial vectors.…”

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confidence: 99%

“…Caps(11)(12)(13)(14)(15)(16)(17)(18)(19) 26. DOWNs TD, LIFBmMAN J: Statistical methods for vectorcardiographic directions.…”

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Quantitation of the Normal Frank and McFee-Parungao Orthogonal Electrocardiogram in the Adolescent

et al. 1973

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A detailed linear, circular and spherical quantitation of the Frank and McFee-Parungao orthogonal electrocardiograms of 166 adolescents is presented.There are significant differences between pubescent males and females: (1) QRS and T magnitudes in the male are greater than in the female.(2) The difference in magnitudes is greater at age 11-15 than at age 16-19, presumably because females reach puberty earlier. (3) The differences in magnitudes are on the X and Z axes but not the Y axis. (4) Males achieve their maximal posterior QRS orientation sooner than females and are more superior as it occurs. (5) The female's T vector is less anterior than the male's. (6) The angular deviation of T from QRS is less in females than males for the horizontal and sagittal planes.There are significant differences between the two lead systems: (1) The McFee-Parungao's voltages are greater than those of the Frank system. (2) On the X axis, the Frank leftward vector is 62% of the McFee, but the terminal rightward vector is 85% of the McFee. (3) On the Y axis, the Frank inferior vector is 76% of the McFee, but initial superior is 90% and the terminal superior 62% of the McFee. (4) On the X axis, 25% is terminally to the right in the Frank, but only 15% in the McFee. (5) The Frank system is oriented slightly more posterior than the MeFee, though the T vectors are not oriented differently.There is no evidence that the spatial QRS and T orientations are related to each other.Additional Indexing Words: Vectorcardiogram T HERE HAVE been numerous studies of normal populations of adults'-7 and chil-dren81-7 using orthogonal dipolar and nonorthogonal vectorcardiographic lead systems, but there has been none for the adolescent. The only quantitative analysis for the normal adolescent either utilized standard electrocardiography'8 or included only a small population as part of a larger group.'7 Most of the quantitations at all ages have been limited and few have used appropriate statistics for circular or spherical data. It has been suggested that the McFee-Parungao system is more orthogonal than Frank's'9 and that it is less distorted in children.20 21Nonetheless, there has been very little data in children with that system.15' 17 From theWe have recently published a very detailed quantitation of both the Frank22 and McFee-Parungao23 orthogonal electrocardiographic systems from age two to nineteen years.'7 Since there were only 105 children included and since there is such great variation with aging, the major importance is that the publication provides a model for complete linear, circular and spherical quantitation and statistical analysis of electrocardiographic data. The present publication is an analysis of 166 adolescents between the ages of 11 and 19 years. It includes 57 subjects from the previous report. Material and MethodsThe 166 normal adolescents were all children of University faculty or University Hospitals personnel, or students in the Cleveland School System. There were an approximately equal number of black and white. All w...

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Section: Ratios Of Maximal Projectionsmentioning

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Quantitation of the Normal Frank and McFee-Parungao Orthogonal Electrocardiogram in the Adolescent

et al. 1973

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“…Only limited data are available for adults'3"19 and children. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] We have published a very detailed quantification of both the Frank and McFee-Parungao orthogonal electrocardiographic systems from age two to 19 years. 36 That study Frank spatial voltages are 70% of those of McFee.…”

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Quantification of the normal Frank and McFee-Parungao orthogonal electrocardiogram at ages two to ten years.

Kan¹,

Liebman²,

Lee³

et al. 1977

Circulation

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A quantification of the Frank and McFee-Parungao orthogonal electrocardiogram of 175 normal children, ages 2-10 years is presented. There are significant differences in age groups 2-5 and 6-10. The QRS voltages of the younger group demonstrate 1) greater Z anterior, 2) greater initial X right, 3) greater terminal X right, 4) smaller Y inferior, and 5) the T vector is oriented more posteriorly. There are significant differences between the two lead systems. 1) Frank spatial voltages are 70% of those of McFee. 2) Frank X left is 70% of McFee, but terminal X right is 75% and initial X right is 60% of McFee. 3) Frank Y inferior is 78% of McFee, but initial Y superior is 83% and terminal Y superior 61% of McFee. 4) Frank Z anterior is 64% and Frank Z posterior is 70% of McFee. 5) In terms of ratios the Frank is relatively less inferior, about equally posterior and more terminally right. 6) The T vector is more posterior in Frank than McFee.

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“…A few papers have described normal ranges in a limited number of children (Hugenholtz and Liebman, 1962;Liebman et al, 1966;Ainger, 1967;Khoury and Fowler, 1967;Gamboa and White, 1968;Liebman et al, 1971;Liebman et al, 1973) but more extensive studies are needed. In our laboratories, a project has been established to define normal values for 3 orthogonal lead electrocardiographic measurements derived from the modified axial lead system (Macfarlane, 1969) applied to a large population of infants and children.…”

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Modified axial lead system in children.

Macfarlane

Coleman²,

Simpson³

1977

Heart

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Preliminary studies have been made on the use of the modified axial lead system in infancy and childhood. A highly significant correlation between internipple distance and height suggested that internipple distance be used as an index for the selection of a template to facilitate placement of the chest electrodes (Z and X). A series of 4 triangular templates was designed. The use of a template one size too large or too small was shown not to lead to any significant error in waveform measurement. A further study showed that the reference levelfor the application of the praecordial electrodes should be the 5th intercostal space as for adults, but that no serious diagnostic error was likely to arise if the 4th or 6th intercostal space was chosen by mistake. A study of the Frank lead system suggested that the use of the 5th intercostal space as a reference level was more appropriate than the 4th intercostal space, which is generally adopted by users of that system. The conclusion reached was that the axial lead system is the preferred orthogonal lead system for children, with templates for 4 ranges of internipple distance (<10 cm; 10 to 15 cm; 15 to 20 cm; and >20 cm-adult build) being proposed to simplify electrode placement.

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The corrected orthogonal electrocardiogram in normal children

Cited by 8 publications

References 32 publications

Quantitation of the Normal Frank and McFee-Parungao Orthogonal Electrocardiogram in the Adolescent

Quantitation of the Normal Frank and McFee-Parungao Orthogonal Electrocardiogram in the Adolescent

Quantification of the normal Frank and McFee-Parungao orthogonal electrocardiogram at ages two to ten years.

Modified axial lead system in children.

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