Precordial bipolar leads: A new method to study anterior acute myocardial infarction. 2020

Mario J Mc Loughlin
Fundación Centro Diagnóstico Nuclear, Av. Nazca 3449, C1417CVE Buenos Aires. Argentina. Electronic address: mario.mcloughlin@gmail.com.

A new ECG method produces Precordial Bipolar Leads (PBL) generated by subtraction of measurements of Standard Precordial Unipolar Leads (SPUL). This procedure brings new information about time/amplitude mismatch among SPUL, presenting it as tracings and local VCG loops exploring the precordial left-to-right axis on the horizontal plane. In this study, results of V2-V1 bipolar precordial derivation V2-V1 (right to left) and its relationship with the anteroposterior axis are presented. Records of 37 patients and 15 controls from Physionet database were used to create new PBL and compare between V1 and V2 SPUL. So, bipolar V2-V1 was obtained by subtracting V1 measurements from V2, always having as positive the V2 SPUL and as negative V1. The algorithm used was subtracting, in every millisecond, the voltage recorded by the right electrode from the simultaneously recorded left electrode. Combination of SPUL and PBL can be presented as tracings or local loops, showing detailed information of the electric horizontal plane of the heart at retrosternal location. PBL V2-V1 reflects right ventricle and septal electric activity. The new method is able to detect changes in vectors and differences of milliseconds between SPUL and presents new and important information about the right-to-left electric axis. Right ventricle and interventricular septum electric activity can be differentiate in anterior AMI and LBBB. Time/amplitude mismatch between SPUL could be the source of abundant and new information about cardiac depolarization and repolarization. As data to obtain PBL and new loops are already obtained in any ECG device that records simultaneously 12 leads, the system can be added to ECG software algorithms without any additional cable or recording work.

UI MeSH Term Description Entries
D009203 Myocardial Infarction NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION). Cardiovascular Stroke,Heart Attack,Myocardial Infarct,Cardiovascular Strokes,Heart Attacks,Infarct, Myocardial,Infarction, Myocardial,Infarctions, Myocardial,Infarcts, Myocardial,Myocardial Infarctions,Myocardial Infarcts,Stroke, Cardiovascular,Strokes, Cardiovascular
D004562 Electrocardiography Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY. 12-Lead ECG,12-Lead EKG,12-Lead Electrocardiography,Cardiography,ECG,EKG,Electrocardiogram,Electrocardiograph,12 Lead ECG,12 Lead EKG,12 Lead Electrocardiography,12-Lead ECGs,12-Lead EKGs,12-Lead Electrocardiographies,Cardiographies,ECG, 12-Lead,EKG, 12-Lead,Electrocardiograms,Electrocardiographies, 12-Lead,Electrocardiographs,Electrocardiography, 12-Lead
D006352 Heart Ventricles The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation. Cardiac Ventricle,Cardiac Ventricles,Heart Ventricle,Left Ventricle,Right Ventricle,Left Ventricles,Right Ventricles,Ventricle, Cardiac,Ventricle, Heart,Ventricle, Left,Ventricle, Right,Ventricles, Cardiac,Ventricles, Heart,Ventricles, Left,Ventricles, Right
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000465 Algorithms A procedure consisting of a sequence of algebraic formulas and/or logical steps to calculate or determine a given task. Algorithm
D056988 Anterior Wall Myocardial Infarction MYOCARDIAL INFARCTION in which the anterior wall of the heart is involved. Anterior wall myocardial infarction is often caused by occlusion of the left anterior descending coronary artery. It can be categorized as anteroseptal or anterolateral wall myocardial infarction. Acute Anterior Wall Myocardial Infarction,Anterolateral Myocardial Infarction,Anteroseptal Myocardial Infarction,Myocardial Infarction, Anterior Wall,Anterolateral Myocardial Infarctions,Anteroseptal Myocardial Infarctions,Infarction, Anterolateral Myocardial,Infarction, Anteroseptal Myocardial,Infarctions, Anterolateral Myocardial,Infarctions, Anteroseptal Myocardial,Myocardial Infarction, Anterolateral,Myocardial Infarction, Anteroseptal,Myocardial Infarctions, Anterolateral,Myocardial Infarctions, Anteroseptal

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