Vectorcardiograms synthesized from 12-lead ECGs: A new method applied in 1792 healthy children
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The conventional 12-lead electrocardiogram (ECG) is the completely dominating recording technique in electrocardiography despite the superiority of the Frank vectorcardiogram (VCG) in certain situations. In adult cardiology, methods for synthesizing the VCG from the 12-lead ECG have been introduced to improve the interpretation of the 12-lead ECG by permitting VCG analysis in addition.
A new method for synthesizing VCGs from 12-lead ECGs is presented and the resulting “12-lead VCGs” compared to Frank VCGs in a group of 21 children. There was good agreement between the two VCG methods. In addition, the “12-lead VCG” was studied in a group of 1792 apparently healthy children. A clockwise inscription of the loop in the horizontal plane was found in less than 1% of children above 1 month of age. The maximal QRS vector in the frontal plane was directed inferiorly and to the left in children older than 1 month of age, while its direction was superior and to the left in only seven children (0.4%).
The usefulness of the 12-lead VCG as a tool in ECG interpretation still has to be assessed, but the normal limits presented here represent an important base for further study.
Key wordsElectrocardiography Vectorcardiography Normal limits Computer-assisted ECG diagnosis Children
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- 1.Brohet CR, Derwael-Barchy C, Robert A, et al. (1983) Computer interpretation of pediatric Frank vectorcardiograms in the evaluation of congenital heart disease.Am J Cardiol 52:127–132Google Scholar
- 2.Brohet CR, Hoeven C, Robert A, Derwael C, Fesler R, Brasseur LA (1986) The normal pediatric Frank orthogonal electrocardiogram: variations according to age and sex.J Electrocardiol 19:1–14Google Scholar
- 3.Brohet CR (1990) Special value of the vectorcardiogram in pediatric cardiology.J Electrocardiol 23 (suppl):58–62Google Scholar
- 4.Chou TC (1986) When is the vectorcardiogram superior to the scalar electrocardiogram?J Am Coll Cardiol 8:791–799Google Scholar
- 5.Dower GE, Machado HB, Osborne JA (1980) On deriving the electrocardiogram from vectorcardiographic leads.Clin Cardiol 3:87–95Google Scholar
- 6.Edenbrandt L, Pahlm O (1988) Vectorcardiogram synthesized from a 12-lead ECG: superiority of the inverse Dower matrix.J Electrocardiol 21:361–367Google Scholar
- 7.Edenbrandt L, Pahlm O, Lyttkens K, Albrechtsson U (1990) Improved ECG interpretation using synthesized VCG for the diagnosis of inferior myocardial infarction.J Electrocardiol 23:207–211Google Scholar
- 8.Francis DB, Miller BL, Benson DW Jr (1981) A new computer program for analysis of pediatric scalar electrocardiograms.Comput Biomed Res 14:63–77Google Scholar
- 9.Frank E (1954) The image surface of a homogeneous torso.Am Heart J. 47:757–768Google Scholar
- 10.Frank E (1956) An accurate, clinically practical system for spatial vectorcardiography.Circulation 13:737–749Google Scholar
- 11.Garson A (1987) Clinically significant differences between the “old” analog and the “new” digital electrocardiograms.Am Heart J 114:194–197Google Scholar
- 12.Kors JA, van Herpen G, Sittig AC, van Bemmel JH (1990) Reconstruction of the Frank vectorcardiogram from standard electrocardiographic leads: diagnostic comparison of different methods.Eur Heart J 11:1083–1092Google Scholar
- 13.Liebman J (1989) Electrocardiography in congenital heart disease. In: Macfarlane PW, Lawrie TDV (eds)Comprehensive electrocardiology. Pergamon Press, Oxford, pp 729–798Google Scholar
- 14.Macfarlane PW, Coleman EN, Pomphrey EO, McLaughlin S, Houston A, Aitchison TC (1989) Normal limits of the high-fidelity pediatric ECG.J Electrocardiol 22 (suppl): 162–168Google Scholar
- 15.Macfarlane PW, Coleman EN, Devine B, et al. (1990) A new 12-lead pediatric ECG interpretation program.J Electrocardiol 23 (suppl):76–81Google Scholar
- 16.Macfalane PW, Devine B, Latif S, McLaughlin S, Shoat DB, Watts MP (1990) Methodology of ECG interpretation in the Glasgow program.Method Inform Med 29:354–361Google Scholar
- 17.Perry LW, Pipberger HV, Pipberger HA, McManus CD, Scott LP (1986) Scalar, planar, and spatial measurements of the Frank vectorcardiogram in normal infants and children.Am Heart J 111:721–730Google Scholar
- 18.Willems JL, Abreu-Lima C, Arnaud P, et al. (1991). The diagnostic performance of computer programs for the interpretation of electrocardiograms.N Engl J Med 325:1767–1773Google Scholar
- 19.Willems JL, Poblete PF, Pipberger HV (1972). Day-to-day variation of the normal orthogonal electrocardiogram and vectorcardiogram.Circulation 45:1057–1064Google Scholar
- 20.Zywietz C, Klusmeier S, Bernsau U (1977) New VCG analysis program for children with multivariate diagnostic classification. In: Ostrow HG, Ripley KL (eds) IEEE Computer Society, proc Comp in Cardiology, pp 95–100Google Scholar