Interpretation Note

The following pages with varied loops shall be a useful help regarding interpretation of automatic diagnostic findings by the physician.
Each loop is as unique and individual as a human fingerprint.
Therefore there are some cases of disease patterns and findings.

 

Vector Loops

The results of X, Y and Z are ascertained for every milisecond and transferred to a three-dimensional graphic. By linking of all points loops emerge.

  • Grey: Depolarization atria (correlates to P wave on the surface ECG)
  • Blue: Depolarization ventricle (correlates to QRS complex on the surface ECG)
  • Green: Repolarization ventricle (correlates to T wave on the surface ECG)

Healthy Subject

Vector loops proceed in similar pathways for R and T maximum vectors (Rmax and Tmax, yellow) and point to the cardiac apex in a narrow angle between Rmax and Tmax (ϕ)

Sick Subject

Vector loops do not follow similar pathways

  • „„Maximum vectors deviate from the cardiac apex
  • The angle between Rmax and Tmax is wide (ϕ)
  • „„Vector loops are relatively small -> reduced potentials
  • „„Additional doctoral evaluation is necessary

Maximum Vectors

The maximum vectors of the loops are transferred into the “globe view”. Perspective: from the cardiac apex (90° alpha and 0° beta) onto the left ventricle.

Longitude and latitude allow spatial mapping.

  • Rmax: blue squares; Tmax: green triangles
  • Pmax: grey circles (illustration optional)
  • Red square/triangle: median
  • Yellow square/triangle: selected beat
  • Reference range for Rmax: blue area (depicted only if parameter set NORM is used)
  • Reference range for Tmax: green area (depicted only if parameter set NORM is used)

Deficiency Symptom:
Reduced potentials in deficiently supplied area

  • Vector points away from problematic area to the best supplied area
  • Mirroring of current vector position at the cardiac apex (or suspected normal positions of the vectors) points to the problematic area

Heavy Spreading

  • acute Event, slight spreading prn. breathing-induced

Hypertrophy:
More mycardial mass next to the cardiac apex

  • Vector points to the area with the greatest potential
  • No mirroring necessary

Hybrid forms possible (hypertrohpy with ischemia)

Healthy Subject (See Vector Loops)

„„ Rmax focussed in reference range

  • points to the cardiac apex
  • most myocardial mass apical
  • highest potential

Tmax focussed in

 

  • points to cardiac apex
  • highest blood flow apical

Sick Subject (See Vector Loops)

Rmax is spreading and deviates from the apex

  • „„acute infarction
  • Mirroring of current vector positions shows the problem in Octant 2 = apical diaphragmal, septal

Tmax is spreading, however, still in reference range

  • acute ischemia
  • smal area affected, so Tmax still points apical

Potentials

 

Changes in repolarization (T) Changes in depolarization (R)
Stable Deviation of T maximum vectors from the reference range

-> Suspicion of CAD
Deviation of R maximum vectors from the reference range

-> Suspicion of scar or LVH
Acute Spreading of T maximum vectors

-> Suspicion of acute ischemia, IAP
Spreading of R maximum vectors

-> Suspicion of acute infarction

Atrial fibrillation

Potentials during P very low; no clear peak definable; because of atrial fibrillation there is no organized spread of impulses and therefore also no maximum vector

ST Segment red

If there are decreasing results of potentials in the ST segment, it will be depicted red. This is the equivalent to ST deviation in an ECG. The transition to T begins only when the results of the potentials are increasing. Unfortunately there can also be red ST segments in healthy patients, whose interpretation has not been successful, yet.

AV Blocking and Intraventricular Conduction Disturbance

Duration of P > 200 ms: This indicates a dysfunction of the transition from the atria into the cardiac chambers.

Duration of R ≥ 122 ms: This indicates a dysfunction of the conduction during the transition into the ventricles. For that impulses are transferred from one muscle cell to the next. This process ist slower than the transmission in the cardiac conduction system.

Potential with Left Bundle Branch Block

The left bundle branch block shows a compact cone in the R potential and a distinctly bigger and more massive ST segment as a result of a dissociated repolarization.

Potential with Right Bundle Branch Block

The right bundle branch block shows a bimodal R potential whereas usually the first peak forms the maximum vector.

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