Optimal electrocardiographic limb lead set for rapid emphysema screening

International Journal of Chronic Obstructive Pulmonary Disease
Rishi BajajD H Spodick


Pulmonary emphysema of any etiology has been shown to be strongly and quasidiagnostically associated with a vertical frontal P wave axis. A vertical P wave axis (>60 degrees) during sinus rhythm can be easily determined by a P wave in lead III greater than the P wave in lead I (bipolar lead set) or a dominantly negative P wave in aVL (unipolar lead set). The purpose of this investigation was to determine which set of limb leads may be better for identifying the vertical P vector of emphysema in adults. Unselected consecutive electrocardiograms from 100 patients with a diagnosis of emphysema were analyzed to determine the P wave axis. Patients aged younger than 45 years, those not in sinus rhythm, and those with poor quality tracings were excluded. The electrocardiographic data were divided into three categories depending on the frontal P wave axis, ie, >60 degrees, 60 degrees, or <60 degrees, by each criterion (P amplitude lead III > lead I and a negative P wave in aVL). Sixty-six percent of patients had a P wave axis > 60 degrees based on aVL, and 88% of patients had a P wave axis > 60 degrees based on the P wave in lead III being greater than in lead I. A P wave in lead III greater than that in lead I is a more sensitive mark...Continue Reading


Jan 1, 1974·The American Review of Respiratory Disease·W M ThurlbeckR G Frazer
Mar 20, 1999·Clinical Cardiology·R Baljepally, D H Spodick
Mar 1, 1960·The American Journal of Cardiology·D LITTMANN
Feb 11, 2011·The American Journal of Cardiology·Anish J ThomasD H Spodick
Sep 13, 2011·Journal of Electrocardiology·Lovely Chhabra, D H Spodick


May 22, 2013·International Journal of Chronic Obstructive Pulmonary Disease·Lovely ChhabraD H Spodick
Aug 25, 2015·International Journal of Cardiology·N Gurukripa Kowlgi, Lovely Chhabra
May 15, 2016·Heart & Lung : the Journal of Critical Care·Atsushi IchikawaTetsuro Sugiura

Related Concepts

Electrocardiographic Recorders
Focal Emphysema
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Biological Markers
Limb Structure
Genetic Vectors
Pulmonary Emphysema
Electrocardiographic Monitoring

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