Value of the bipolar lead CM5 in electrocardiography.

Quyyumi, AA; Crake, Tom; Mockus, L; Wright, Christine; Rickards, A F; Fox, Kim

doi:10.1136/hrt.56.4.372

Cited by 28 publications

(13 citation statements)

References 8 publications

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“…The resulting precordial bipolar lead CM 5 has been found to have the highest sensitivity for the detection of exercise-induced subendocardial ischemia among commonly used single leads. 33 This results from the general axis of the lead along the LV cavity from base to apex and also from the high lead strength of the electrode pair in this position.…”

Section: Electrocardiographic Leads For Exercise Testingmentioning

confidence: 99%

Exercise Standards for Testing and Training

Fletcher¹,

Ades²,

Kligfield³

et al. 2013

Circulation

1,634

760

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Section: Electrocardiographic Leads For Exercise Testingmentioning

confidence: 99%

Exercise Standards for Testing and Training

Fletcher¹,

Ades²,

Kligfield³

et al. 2013

Circulation

1,634

760

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“…However, it fails to detect ST elevations produced by ante rior or inferior myocardial ischemia [2]. In fact.…”

Section: Comparison With 12-lead Ecgmentioning

confidence: 99%

“…ST changes, par ticularly ST elevations, produced by inferior wall ischemia may be missed because only precordial leads are usually used [2], Jespersen and Rasmussen [10] reported that a modified orthogonal Y lead was suitable for the detection of inferior myocardial ischemia. They attached the anode to the iliac crest and the cathode to the superior angle of the scapu la.…”

Section: Comparison With 12-lead Ecgmentioning

confidence: 99%

“…on the other hand, the frequency and duration of myocardial ischemia occurring during daily activities can be determined [1], but the extent of ischemia cannot be assessed because of the limited number of leads. This method may also fail to detect right coronary artery disease [2] or miss ischemic ST changes that are shown by leads I and aVL of the 12-lead ECG [3], because the recording sites are restricted to the anterior wall.…”

Section: Introductionmentioning

confidence: 99%

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Correlation of Coronary Artery Stenosis Site with Anterior or Inferior Projection of ST Changes Induced by Treadmill Exercise Using a Newly Devised 9-Lead Holter Method

Tanabe

Yoshioka²,

Takahasi³

et al. 1992

Cardiology

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A 9-lead Holter monitor using the lead-switching technique (9-lead DCG) and conventional 12-lead electrocardiograph (12-lead ECG) were simultaneously used for recording during treadmill exercise testing (Td-test) in 140 patients with coronary artery disease. Coronary arteriography was performed in 118 of the 140 patients, and the correlation between coronary stenosis and anterior or inferior projection of ST depressions occurring during the Td-test was investigated. Additionally, 10 patients with acute myocardial infarction (AMI) were studied to test ST elevation detection by the 9-lead DCG. The CM5 lead demonstrated ST depressions in 92 of the 109 patients showing ST depressions in one or more leads. High lateral (HL) and/or low lateral leads detected all ST depressions occurring in the I and aVL leads of the 12-lead ECG. Leads CM1, CM2 and CM3 exhibited low sensitivity (0-32%) and high specificity (56-100%), while leads CM4, CM5, and CM6 provided greater sensitivity (66-95%), but less specificity (3-32%) in detecting diseases of the left anterior descending artery, left circumflex artery and/or right coronary artery (RCA). In contrast, the low back (LB) lead demonstrated high sensitivity (88%) and high specificity (86%) in detecting RCA disease. Lead CM3 detected ST elevations in all 6 patients with anterior AMI, while the LB lead did so in all 4 patients with inferior AMI. With a Holter monitor, 4 leads are needed: CM5 like, CM3 like, lateral (such as HL) and inferior (such as LB). The LB lead is useful in detecting inferior ischemia.

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“…This is due to the suboptimal performance in detecting ST depression compared to multiple lead systems [8]. Previous work on BCLs has primarily focused on the analysis of the ST-T segment [9]- [11]. In addition, a bipolar precordial lead recorded between V2 and V5 has previously been shown to increase the sensitivity for the detection of type 1 Brugada pattern during ajmaline tests.…”

Section: Bipolar Chest Leadsmentioning

confidence: 99%