Abstract:
:Previous work from the Departments of Cardiology and Nuclear Medicine, Guy's Hospital, London, has enabled an atlas of the electrocardiographic appearances of ectopics from individual ventricular sites to be compiled. This has been used to investigate the relationship between regions of myocardial ischaemia and the site of origin of exercise-induced ventricular arrhythmias. Two hundred and ten patients underwent maximal exercise testing on a bicycle ergometer, prior to thallium scintigraphy. All 12 leads of the electrocardiogram were recorded simultaneously at rest, immediately post-exercise and then for several minutes afterwards. Thallium scintigraphy was performed immediately and 4 hours post-exercise. Twenty-nine patients of the 210 had ventricular arrhythmias on exercise. Two had dilated (congestive) cardiomyopathy, 1 had hypertrophic cardiomyopathy and 26 were subsequently proven to have ischaemic heart disease. Fifteen of those patients with coronary artery disease and ventricular arrhythmias had otherwise negative exercise tests. Patients with reversible posterior (circumflex) defects had right bundle branch block extrasystoles with a limb lead QRS axis of -60 degrees to -150 degrees. Reversible inferior defects demonstrated ectopic activity with left bundle branch block and a superior axis. Ectopics of septal origin could present with either right or left bundle branch block and an inferior axis from the upper septum, or superior axis from the lower septum. In patients with ischaemic heart disease the 12-lead electrocardiographic appearance of ventricular arrhythmias enables their site of origin to be localised thus suggesting ischaemia in a particular coronary artery territory.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
Holt P,Brennand-Roper D,Curry PV,Maisey MNdoi
10.1016/0167-5273(86)90143-9subject
Has Abstractpub_date
1986-11-01 00:00:00pages
185-200issue
2eissn
0167-5273issn
1874-1754pii
0167-5273(86)90143-9journal_volume
13pub_type
杂志文章abstract::To assess the possible role of restoring forces underlying left ventricular wall motion during rapid filling, the time relations between left ventricular dimensions and filling velocity were studied by digitised M-mode and Doppler echocardiography in 23 normal children and 43 patients: 11 with mild and 17 with severe ...
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