What question did this study set out to answer?

To assess the diagnostic significance of high-frequency QRS notching in orthogonal leads for detecting ventricular enlargement in living cardiac patients.

October 1, 1971CirculationOpen Access

Diagnostic Import of QRS Notching in High-Frequency Electrocardiograms of Living Subjects with Heart Disease

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Heart disease (n=92). Intervention: High-frequency electrocardiography vs. Patients with no ventricular enlargement. Primary outcome: Total QRS notch count.

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Key result

High-frequency QRS notch count correlated with ventricular enlargement, with a mean of 2.9 notches in normal ventricles, 5-6 in single enlargement, and 8.6 in biventricular enlargement.

Why the study?

Does QRS notch count on high-frequency electrocardiograms correlate with ventricular enlargement in patients with heart disease?

Key Points

To assess the diagnostic significance of high-frequency QRS notching in orthogonal leads for detecting ventricular enlargement in living cardiac patients.
Evaluated 92 patients with heart disease over a 10-month period using high-frequency, high-speed orthogonal leads (X, Y, and Z), routine ECG, barium radiography, cardiac catheterization, and left ventricular angiography.
Stratified 69 non-surgical patients with normal ventricular activation duration into four groups: no ventricular enlargement, isolated right ventricular enlargement, isolated left ventricular enlargement, and biventricular enlargement.
Patients without ventricular enlargement presented with a mean of 2.9 notches and never exceeded a total notch count of 6.
Patients with isolated single ventricular enlargement exhibited mean notch counts between 5 and 6.
Patients with biventricular enlargement had a mean of 8.6 notches, frequently exceeding 6 notches and significantly separating them from normal controls without diagnostic overlap.

Study Design

Type

Observational (n=92)

Structured PICO

Does QRS notch count on high-frequency electrocardiograms correlate with ventricular enlargement in patients with heart disease?

Population

92 patients with heart disease (69 analyzed who had no prior cardiac surgery and normal duration of ventricular activation)

Intervention

High-frequency electrocardiograms (orthogonal leads X, Y, and Z)

Comparator

Reference standard: radiographic, hemodynamic, and angiographic evidence of ventricular enlargement

Outcome

Correlation of QRS notch count with ventricular enlargementsurrogate

High-frequency QRS notch count correlates well with dynamic evidence of ventricular enlargement, with biventricular enlargement showing significantly higher counts.

Discussion

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Implication

Hypothesis-generating for QRS notch count in ventricular assessment; prospective validation required before clinical consideration.

Cite This Study

Flowers et al. (1971) conducted an observational in Heart disease (n=92). High-frequency electrocardiography vs. Patients with no ventricular enlargement was evaluated on Total QRS notch count. High-frequency QRS notch count correlated with ventricular enlargement, with a mean of 2.9 notches in normal ventricles, 5-6 in single enlargement, and 8.6 in biventricular enlargement.

synapsesocial.com/papers/6a0ba8a14f6759c6fca253a8 https://doi.org/10.1161/01.cir.44.4.605

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Diagnostic Import of QRS Notching in High-Frequency Electrocardiograms of Living Subjects with Heart Disease

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Diagnostic Import of QRS Notching in High-Frequency Electrocardiograms of Living Subjects with Heart Disease

Key Points

Study Design

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

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