A unified way to assess the electrical axis displacement of the heart

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Abstract

As new electrophysiological and clinical information about the heart becomes available, the importance of determining the spatial orientation of the electrical axis of the heart is increasing in practical medicine. Suffice it to mention that displacement of the electrical axis of the heart is one of the cardinal symptoms of partial blocks of the left Gis bundle. At the same time, the evaluation of the electrical axis, limited to its projection on the frontal plane, and the terminology of the axis deviation, established many years ago, do not reflect the new trends in electrocardiography and need to be adjusted accordingly.

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A. G. Latypov

Kazan Lenin Institute for Advanced Medical Education

Author for correspondence.
Email: info@eco-vector.com
Russian Federation, Kazan

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2. Fig. 1. ECG of patient V., 57 years old. Diagnosis: chronic pulmonary heart. The electrical axis of the heart is directed to the right upwards (∠α = -120°). In practice, doctors find it difficult to describe such axis deviation and limit themselves to stating S-type ECG changes.

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3. Fig. 2. ECG of patient B, Acute transmural extensive anterior myocardial infarction in 1973 at the age of 39: a) from May 23, 1973. the electrical axis of the heart was directed downward (∠α = +90°) as it was before the disease; b) from 16. 07.07.73. In the process of dynamic development of myocardial infarction, the axis shifted to the left-upward from the initial state and acquired a false "normal" position (∠α = +38°); c) from 08/25/80. As a result of the left-up shift, the axis acquired a new position - it deviated left-up (∠α = -20°). Thus, the "normal" position of the electrical axis in B., which had been present for several years, was not an indication of the norm.

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4. Fig. 3. ECG of patient A., 24 years old, dated September 5, 1985. Electrical axis of the heart is directed backward, perpendicular to the axes of limb leads.

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