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Abstract:
BackgroundDepolarization abnormalities are hardly detectable by standard 12-lead electrocardiogram (ECG) in some patients. ObjectiveTo evaluate the value of the 16-lead High-Definition (HD)-ECG machine to record conduction abnormalities including Epsilon waves in patients with structural heart disease. MethodsTracings with 12-lead ECG, 16-lead HD-ECG, and signal-averaged ECG were studied. Results(1) Case of severe coronary artery disease (CAD): On 16-lead HD-ECG, a tiny intra-QRS signal was noted in lead III, a prolonged P wave in lead II, and fragmentation on top of lead aVL and lead aVF. Proper automatic measurement of the prolonged P wave measuring 190ms was noted. Signal-averaging by 16-lead HD-ECG in lead III showed the intra-QRS fragmentation and P wave prolongation of 180ms. (2) First patient with arrhythmogenic right ventricular dysplasia (ARVD): Standard 12-lead ECG indicated Epsilon waves in lead III, V2, V3, and inverted T waves in V1-V3. 16-lead HD-ECG indicated QRS prolongation in lead II, III, aVL, aVF, V2, V3 as opposed to V6, and low amplitudes of QRS complexes in V4R and V3R as a new possible sign of ARVD. Notches in lead V2, widening of QRS complexes in all precordial leads, but shorter QRS in V8-V9 are also considered as a potential new diagnostic sign of ARVD. (3) Second ARVD patient: Notches at the end of the QRS in lead III and a negative initial deflection of the QRS in V1 and V2 were detected by standard 12-lead ECG. On 16-lead HD-ECG, a more pronounced QRS fragmentation was visible. Conclusion16-lead HD-ECG in both CAD and ARVD seems to be more sensitive than 12-lead ECG to record electrocardiographic abnormalities.
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Source :
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY
ISSN: 0147-8389
Year: 2018
Issue: 6
Volume: 41
Page: 643-655
1 . 3 4
JCR@2018
1 . 9 7 6
JCR@2020
ESI Discipline: CLINICAL MEDICINE;
ESI HC Threshold:114
JCR Journal Grade:2
CAS Journal Grade:4
Cited Count:
WoS CC Cited Count: 4
SCOPUS Cited Count: 6
ESI Highly Cited Papers on the List: 0 Unfold All
WanFang Cited Count:
Chinese Cited Count:
30 Days PV: 0
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