Details

Autor(en) / Beteiligte

• Macruz, Radi
• Tranchesi, João
• Ebaid, Munir
• Pileggi, Fúlvio
• Romero, Alfredo
• Décourt, Luiz V.

Titel

Ebstein's disease: Electrovectorcardiographic and radiologie correlations

Ist Teil von

• The American journal of cardiology, 1968, Vol.21 (5), p.653-660

Ort / Verlag

Elsevier Inc

Erscheinungsjahr

1968

Quelle

Elsevier Journal Backfiles on ScienceDirect (DFG Nationallizenzen)

Beschreibungen/Notizen

• The electrocardiograms and vectorcardiograms of 12 patients with Ebstein's disease are analyzed and correlated with the radiologie findings. In 6 patients, there was anatomic confirmation, in 3 during surgery for implantation of a Starr-Edwards prosthesis in the right atrioventricular ring and in 3 by autopsy. In the 6 remaining patients, the confirmation was made by angiocardiographic studies. A tendency to normal heart rate or bradycardia was observed in most cases. In all, the diagnosis of right atrial overloading could be made by analyzing the amplitude, configuration and durations of the P wave and P-R interval. The duration of the P wave was greater than normal in 53 per cent of the cases. The duration of the P-R interval was greater than normal in 73 per cent of the cases. There was a clear relation between the increased duration of the P wave and that of the P-R interval. The increases of the P wave and of the P-R interval were closely related to the increase of the cardiac silhouette. The P/P-R segment index was less than 1.2 (considered the mean normal value), in spite of the increase of P wave duration, in all but 1 case. We support the hypothesis that the increase in P wave and P-R interval is dependent mainly on right atrial overloading and not only on congenital conduction disturbance. In the patients with very large hearts, lead V 1 tended to show polyphasic, low voltage QRS complexes, whereas in those with smaller hearts, V 1 tended to show “pure” R waves. An increase in QRS duration was registered in all cases, probably not because of real right bundle branch block but because of intraventricular conduction disturbance. The increase in QRS duration, the configuration in V 1 and the degree of cardiomegaly were closely related. The greater the enlargement of the right heart chambers, the more important were the leftward and posteriorly directed portions of the QRS vectorcardiographic loop. The vectorcardiographic studies demonstrated that the cases of lesser cardiomegaly corresponded to those in which there was increased duration of the QRS complexes in the horizontal plane and predominance of the rightward portions.