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(Circulation. 1956;13:562.)
© 1956 American Heart Association, Inc.

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The Spatial Ventricular Gradient: Intermittent Wolff-Parkinson-White Syndrome, Intermittent Left Bundle Branch Block and Ventricular Premature Contractions

MORDECAI A. BERKUN M.D.¹; RUSSELL H. KESSELMAN M.D.¹; EPHRAIM DONOSO M.D.¹; ARTHUR GRISHMAN M.D.¹

¹ From the Cardiographic Laboratory, The Mount Sinai Hospital, New York, N. Y.

Criteria are given for testing the ventricular gradient concept. The spatial ventricular gradient is then determined in three types of intraventricular conduction disturbances using the cube system of orthogonal bipolar leads. Correction of the isoelectric baseline for the effect of T_P on the QRS and T areas is made. The spatial ventricular gradient remains essentially constant both in magnitude and direction in intermittent Wolff-Parkinson-White syndrome and intermittent left bundle branch block despite marked changes in body surface electrocardiograms. Ventricular premature contractions produce marked deviations in the spatial ventricular gradient. The spatial ventricular gradient merits further study as one of the fundamental quantities in electrocardiography.