Digitized electrocardiograms recorded with bipolar right-infraclavicular leads compared to electrocardiograms recorded with unipolar chest V leads and bipolar lead II

This article presents a method for the evaluation of cardiac depolarizations in a relatively short time with a minimum number of electrodes. With the negative electrode attached to the right infraclavicular region, voltage variations on the chest surface exhibit larger excursions than do the usual unipolar leads. Peak voltages of the PQRST waveforms measured on 12 normal patients by both methods were similar in polarity but were statistically significantly higher in the right infraclavicular leads. Data are presented on 21 normal patients, which show that digitized signals allow for an expanded time-scale leading to higher resolution of rate of change and onset and offset times. The digitized signals also more clearly define notches that distort the QRS complex. In 55 cardiac patients, the 12-lead unipolar electrocardiograms were visually compared to digitized electrocardiograms recorded by using the bipolar right infraclavicular leads. The authors suggest that RIC leads would be most useful in the design of a pocket-sized digitizing bipolar-lead electrocardiograph.