[Electrovectorcardiographic manifestations of supraventricular ectopic rhythms (an interpretive hypothesis)].

A de Micheli, G A Medrano
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Abstract

When a low right atrial rhythm is present, P waves are negative in the low leads, they are variable in a VR and positive in a VL and LI. The figure eighth PF loop is located in the first quadrant, the PH loop has a counterclockwise rotation, and the PS can rotate in either direction. In the presence of upper left atrial rhythms, P waves are positive in the low leads and negative in a VL and a VR. The PF and PH loops can be found in the third quadrant of both planes with a clockwise rotation. If the rhythm originates in low left atrial regions, negative P waves are recorded in left precordial leads and positive ones in a VR and a VL. The PF loop has counterclockwise rotation or its branches superimposed and is situated in the second quadrant; PH with clockwise rotation is registered in the third quadrant; PS with either counterclockwise or clockwise rotation develops above and slightly ahead of the E point. When a nodal rhythm exists, P waves are negative in the low leads. The P loops show a counterclockwise rotation or a figure eight morphology. In the absence of atrial enlargements, the PF loop can be recorded in the first quadrant and the PH in the first or the fourth quadrant.

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[室上异位节律的心电图表现(一种解释性假设)]。
当右心房节律低时,P波在低导联为负,在VR导联为可变,在VL和LI导联为正。图8 PF环位于第一象限,PH环逆时针旋转,PS可在任意方向旋转。在左上心房节律存在时,P波在低导联呈阳性,在左室和右室呈阴性。PF和PH环可以在两个平面的第三象限中以顺时针方向旋转。如果心律起源于左心房下部,则左心前导联记录负P波,而左心前导联记录正P波。PF环路逆时针旋转或其分支重叠,位于第二象限;第三象限为顺时针旋转的PH;PS以逆时针或顺时针方向旋转,在E点上方和略前发展。当节点节律存在时,P波在低导联为负。P环呈逆时针旋转或8字形形态。在没有心房增大的情况下,PF环路可以记录在第一象限,PH记录在第一或第四象限。
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