心电图的数学模型揭示加做右胸和/或后壁导联心电图的不合理性

The mathematical model of electrocardiogram reveals the irrationality of adding right chest and posterior wall lead

目的分析右胸、后壁导联心电图的形态特征及其与左胸、前壁导联的内在联系,探讨加做右胸、后壁导联的心电图是否必要。方法利用《几何画板》的动态作图功能与轨迹跟踪功能,用导联转换的方法,根据正常的心电向量图制作出正常心电图的胸导联数学模型;根据超急性心肌梗死的心电向量图,制作出相应的旋转导联心电图数学模型。结果正常心电图的数学模型大致与实际记录的心电图基本吻合;右胸导联心电图大致是左胸导联心电图的缩小版倒影;后壁导联心电图大致是前壁导联心电图的缩小版倒影。超急性心肌梗死的旋转导联心电图数学模型表明:方向相反的导联是镜像导联,心电图形态全等、方向相反;同一平面内的导联设置不应超过180°,否则会造成信息重复。结论右胸、后壁导联心电图与左胸、前壁导联心电图有信息重复,表明加做右胸、后壁导联心电图不合理。

Objective To investigate the irrationality of adding right chest and posterior wall lead in electrocardiogram(ECG)examination by analyzing the morphological characteristics of the right chest and posterior wall lead ECG and its internal relationship with the left chest and anterior wall lead ECG.Method Using the dynamic mapping function and tracking function of Geometry's Sketchpad,made the mathematical model of the chest lead ECG according to the normal vector cardiogram by means of lead conversion.By the same way,made the mathematical model of the rotating lead ECG according to the ECG of super-acute myocardial infarction.Results The mathematical model of normal ECG was roughly consistent with the actual recorded ECG.The right chest lead ECG was roughly a miniaturized reflection of the left chest lead ECG;the posterior wall lead ECG was roughly a miniaturized reflection of the anterior wall lead ECG.The mathematical model of the rotating lead ECG in super-acute myocardial infarction showed that two leads in opposite directions were mirror leads of each other,and the ECG waveforms were equal-sized and opposite.The lead settings in the same plane should not exceed 180°.Otherwise,information would be repeated.Conclusions The right chest and posterior wall lead ECG overlaps with the left chest and anterior wall lead ECG,so it is unreasonable to add the right chest and posterior wall lead in ECG examination.