Circulation, Vol 54, 213-218, Copyright © 1976 by American Heart Association
MM Bodenheimer, VS Banka, RG Trout, H Pasdar and RH Helfant
To evaluate the relationship between abnormal Q waves on the standard ECG
and localized ventricular excitation, unipolar epicardial electrograms were
recorded over the left ventricle during aortocoronary bypass surgery in 36
patients. Of 20 without standard ECG Q waves, six had abnormal epicardial Q
waves, three anterioly and three inferiorly. Of 16 patients with standard
ECG Q waves, four had both precordial and anterior epicardial Q waves while
seven had Q waves in leads III and aVF and inferior epicardial Q waves.
Three of the 14 had Q waves in both precordial and inferior leads of the
ECG but epicardial Q waves only from the antero-apical region in two and
only from the inferior wall in one. Two patients with Q waves in both III
and aVF had no epicardial Q waves. Thus, the standard electocardiogram
underestimates epicardial Q waves. If Q waves are present in the standard
ECG, they correlate with the presence, although not invariably the location
of Q waves on the epicardial electrogram.
ARTICLES
Correlation of pathologic Q waves on the standard electrocardiogram and the epicardial electrogram of the human heart
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