Article
A Modified Approach To Electrocardiographic Diagnosis Of Left Ventricular Hypertrophy Using The Decarto Method
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Published: | February 8, 2007 |
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Question: There is investigated a method for recognition of left ventricular hypertrophy with the use dipole electrocardiotopography (DECARTO), which provides for intelligible-pictorial visualization of the heart electrophysiological states on the basis of vectorcardiographic signals.
Method Used: The decartogram of activation duration is used. It is a map of distribution of the time during which the depolarization wave moves through the ventricular wall. On this decartogram, the region is considered where the surface of left ventricle is projected according to the anatomy of the heart. The integral index of activation duration (IIAD) is calculated as the activation duration, integrated over the aforementioned region of the left ventricle on the decartogram and multiplied by the magnitude of the maximum depolarization vector.
Results: There were investigated 142 essentially healthy persons and 129 hypertensive patients with moderate and pronounced left hypertrophy, roughly equal numbers of men and women at the age of 40 to 65 years, with the use of the McFee-Parungao lead system. The used threshold values of IIAD provides specificity 95% with sensitivity 62%. On the same experimental set, the following parameters were also tried: the sum of wave amplitudes Rx+Sz of scalar vectorcardiograms in the Frank coordinate system, Sokolov-Layon criterion, and Cornell-product criterion. For these criteria with specificity 95%, the sensitivities 50%, 30%, and 46%, that are lower than for IIAD, were respectively obtained.
Conclusion: The DECARTO technique not only provides an intelligible-pictorial (in the form of decartograms) representation of the vectorcardiographic measurements for efficient heuristic analysis of the measured potentials, but also allows obtaining quantitative characteristics which ensure more accurate diagnosis of the left hypertrophy as compared to commonly accepted electrocardiographic methods.