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. 2007 Aug 2;30(7):319–323. doi: 10.1002/clc.14

Significance of Vectorcardiogram in the Cardiological Diagnosis of the 21st Century

Andrés Ricardo Pérez Riera 1, Augusto H Uchida 2, Celso Ferreira Filho 3, Adriano Meneghini 4, Celso Ferreira 5, Edgardo Schapacknik 6, Sergio Dubner 7,✉, Paulo Moffa 8
PMCID: PMC6652966  PMID: 17674376

Abstract

Until the mid‐1980s, it was believed that the vectorcardiogram presented a greater specificity, sensitivity and accuracy in comparison to the conventional electrocardiogram, in the diagnosis of the different heart diseases. Recent studies revealed that the vectorcardiogram still is superior to the electrocardiogram in very specific situations, such as in the evaluation of electrically inactive areas, in intraventricular conduction disorders combined and/or in association to inactive areas, in the identification and location of ventricular preexcitation, in the differential diagnosis of patterns varying from normal of electrical axis deviation, in the evaluation of particular aspects of Brugada syndrome, and in the estimation of the severity of some enlargements, among others.

With the advent of computerized vectorcardiography, a technology that improves the processing and recording method; a future still promising is expected for this methodology.

In the fields of education and research, vectorcardiography provided a better and more rational insight into the electrical phenomena that occurs spatially, and represented an important impact on the progress of electrocardiography. Although a few medical centers still use the method as a routine, we hope that the use of this resource will not get lost over time, since vectorcardiography still represents a source to enrich science by enabling a better morphological interpretation of the electrical phenomena of the heart. Copyright © 2007 Wiley Periodicals, Inc.

Keywords: vectorcardiogram, electrocardiogram, cardiovascular diagnostic technic, sensitivity, specificity

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References

  • 1. Grishman A, Donoso E. Spatial vectorcardiography I. Mod Concepts Cardiovasc Dis 1961; 30: 687–692. [PubMed] [Google Scholar]
  • 2. Helm RA. Theory of vectorcardiography: a review of fundamental concepts. Am Heart J 1955; 49: 135–159. [DOI] [PubMed] [Google Scholar]
  • 3. Chou TC. Value and limitations of vectorcardiography in cardiac diagnosis. Cardiovasc Clin 1975; 6: 163–178. [PubMed] [Google Scholar]
  • 4. Chou TC. When is the vectorcardiogram superior to the scalar electrocardiogram? J Am Coll Cardiol 1986; 8: 791–799. [DOI] [PubMed] [Google Scholar]
  • 5. Abbott‐Smith CW, Chou T. Vectorcardiographic criteria for the diagnosis of left ventricular hypertrophy. Am Heart J 1970; 79: 361–369. [DOI] [PubMed] [Google Scholar]
  • 6. Pipberger HV, Goldman MJ, Littmann D, Murphy GP, Cosma J, et al.: Correlations of the orthogonal electrocardiogram and vectorcardiogram with constitutional variablesin 518 normal men. Circulation 1967; 35: 536–551. [DOI] [PubMed] [Google Scholar]
  • 7. Bocanegra Arroyo J, Braga JMS, Luna Filho B. Análise crítica do eletrocardiograma e do vetocardiograma no diagnóstico da hipertrofia ventricular esquerda. Rev Soc Cardiol Estado de São Paulo 1994; 4: 353–360. [Google Scholar]
  • 8. Vine DL, Finchum RN, Dodge HT. Comparison of the vectorcardiogram with the electrocardiogram in the prediction of left ventricular size. Circulation 1971; 43: 547–558. [DOI] [PubMed] [Google Scholar]
  • 9. Hurd HP II, Starling MR, Crawford MH. Comparative accuracy of electrocardiographic and vectorcardiographic criteria for inferior myocardial infarction. Circulation 1981; 63: 025–1029. [DOI] [PubMed] [Google Scholar]
  • 10. Brisse B. Clinical vectorcardiography: the Fritz‐Schellong commemorative lecture. Z Kardiol 1987; 76: 65–71. [PubMed] [Google Scholar]
  • 11. Hoffman I, Taymor RC, Morris MH, Kittell I. Quantitative criteria for the diagnosis of dorsal infarction using the Frank Vectorcardigram. Am Heart J 1965; 70: 295–304. [DOI] [PubMed] [Google Scholar]
  • 12. Benchimol A, Desser KB. Advances in clinical vectorcardiography. Am J Cardiol 1975; 36: 76–86. [DOI] [PubMed] [Google Scholar]
  • 13. Lui CY, Ornato JP, Buell JC. Lack of superiority of the vectorcardiogram over the electrocardiogram in detecting inferior wall myocardial infarction regardless of time since infarction. J Electrocardiol 1987; 20: 241–246. [DOI] [PubMed] [Google Scholar]
  • 14. Edenbrandt L, Pahlm O, Lyttkens K. Vectorcardiogram more sensitive than 12‐lead ECG in the detection of inferior myocardial infarction. Clin Physiol 1990; 10: 551–559. [DOI] [PubMed] [Google Scholar]
  • 15. Mehta J, Hoffman I, Smedresman P. Vectorcardiographic, electrocardiographic, and angiographic correlations in apparently isolated inferior wall myocardial infarction. Am Heart J 1976; 91: 699–704. [DOI] [PubMed] [Google Scholar]
  • 16. Tranchesi J, Moffa PJ, Pastore CA. Block of the antero‐medial division of the left bundle branch of His in coronary diseases. Vectrocardiographic characterization. Arq Bras Cardiol 1979; 32: 355–360. [PubMed] [Google Scholar]
  • 17. Nakaya Y, Hiraga T. Reassessment of the subdivision block of the left bundle branch. Jpn Circ J 1981; 45: 503–516. [DOI] [PubMed] [Google Scholar]
  • 18. Inoue H, Nakaya Y, Niki T, Mori H, Hiasa Y. Vectorcardiographic and epicardial activation studies on experimentally–induced subdivision block of the left bundle branch. Jpn Circ J 1983; 47: 1179–1189. [DOI] [PubMed] [Google Scholar]
  • 19. Rosenbaum MB, Yesuron J, Lazzari JO, Elizari MV. Left anterior hemiblock obscuring the diagnosis of right bundle branch block. Circulation 1973; 48: 298–303. [DOI] [PubMed] [Google Scholar]
  • 20. Rosenbaum MB, Elizari MV, Lazzari JO, Halpern MS, Nau GJ. Bilateral bundle branch block: its recognition and significance. Cardiovasc Clin 1971; 2: 151–179. [PubMed] [Google Scholar]
  • 21. Guo X, Jue X, Ruan Y. Model TJ‐IV computer‐assisted vectorcardiogram analysis system. J Tongji Med Univ 2001; 21: 22–81. [DOI] [PubMed] [Google Scholar]
  • 22. Ellison RC, Restieaux NJ. Vectorcardiography in Congenital Heart Disease. A Method for Estimating Severity. p 44. Philadelphia–London‐Toronto: W.B. Saunders Company; 1972,; Chapter 5. [Google Scholar]
  • 23. Ellison RC, Restieaux NJ. Vectorcardiography in Congenital Heart Disease. A Method for Estimating Severity, Valvular Pulmonic Stenosis pp 60–74. Philadelphia–London‐Toronto: W.B. Saunders Company; 1972,; Chapter 6. [Google Scholar]
  • 24. Giorgi C, Nadeau R, Primeau R. Comparative accuracy of the vectorcardiogram and electrocardiogram in the localization of the accessory pathway in patients with Wolff‐Parkinson‐White syndrome: validation of a new vectorcardiographic algorithm by intraoperative epicardial mapping and electrophysiologic studies. Am Heart J 1990; 119: 592–598. [DOI] [PubMed] [Google Scholar]
  • 25. Pastore CA, Moffa PJ, Tobias NM, de Moraes AP, Nishioka SA, et al. Segmental blocks of the right bundle‐branch and electrically inactive areas. Differential electro‐vectorcardiographic diagnosis. Arq Bras Cardiol 1985; 45: 309–317. [PubMed] [Google Scholar]
  • 26. Pastore CA, Moffa PJ, Spiritus MO. Fascicular blocks of the right branch. Standardization of vectorelectrocardiographic findings. Arq Bras Cardiol 1983; 41: 161–166. [PubMed] [Google Scholar]
  • 27. Atarashi H, Ogawa S, Harumi K. Idiopathic VentricularFibrillation Investigators. Three‐year follow‐up of patients with right bundle branch block and ST segment elevation in the right precordial leads: Japanese Registry of Brugada Syndrome. Idiopathic Ventricular Fibrillation Investigators. J Am Coll Cardiol 2001; 37: 1916–1920 [DOI] [PubMed] [Google Scholar]
  • 28. Pérez Riera AR, Ferreira C, Schapachnik E. Value of 12 lead electrocardiogram and //derived methodologies in the diagnosis of Brugada disease” In The Brugada Syndrome From Bench to Bedside. (Eds. Antzelevich C, Brugada P, Brugada J, Brugada R.),pp 87–110. Futura: Blackwell; 2005,; Chapter 7. [Google Scholar]
  • 29. Riera AR, de Cano SJ, Cano MN. Vector electrocardiographic alterations after percutaneous septal ablation in obstructive hypertrophic cardiomyopathy. Possible anatomic causes. Arq Bras Cardiol 2002; 79: 466–475. [DOI] [PubMed] [Google Scholar]
  • 30. Guo XM, Que XH, Ma YX, Wang ZC. Development and applications of an auto‐analyzing system for model TJ‐IV vector‐cardiogram. Zhongguo Yi Liao Qi Xie Za Zhi 2005; 29(1): 19–22. [PubMed] [Google Scholar]
  • 31. Rautaharju PM. A hundred years of progress in electrocardiography. 2: The rise and decline of vectorcadiography. Can J Cardiol 1998; 4: 60–71. [PubMed] [Google Scholar]
  • 32. Grishman A, Donoso E. Spatial vectorcardiography II. Mod Concepts Cardiovasc Dis 1961; 30: 693–696. [PubMed] [Google Scholar]
  • 33. Benchimol A, Desser KB, Schumacher J. Left anterior hemiblock from inferior infarction with left axis deviation. Chest 1972; 61: 74–76. [DOI] [PubMed] [Google Scholar]

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