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(Circulation. 1967;35:195.)
© 1967 American Heart Association, Inc.

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High-Frequency Components in the Electrocardiogram

A Comparative Study of Normals and Patients with Myocardial Disease

ERNEST W. REYNOLDS JR. M.D.¹; BERNARD F. MULLER M. C.¹; GARY J. ANDERSON M.D.¹; BRUCE T. MULLER ¹

¹ From the Department of Internal Medicine (Heart Station), University of Michigan Medical Center, Ann Arbor, Michigan.

Expanding the frequency response of the electrocardiogram and its derivative to 1,000 cps revealed notching in certain parts of the QRS complex which correlates with the presence of primary myocardial disease. Chi-square analysis of data from 169 patients with myocardial involvement indicated that notching on the downstroke of leads X, V₄, and V₆ separated abnormal from normal patients at the 1% level of significance, whereas fine and coarse slurring showed reverse correlation at the 1% level of significance. This suggests that notching and not slurring is the important evidence of disease. Neither notching nor slurring was significant at the peak of the R wave in any lead. Study of individual cases revealed that complete right and left bundle-branch blocks do not mask high-frequency components caused by myocardial disease nor do they produce high-frequency components. Conclusions regarding specific diagnostic nostic criteria, however, should serve only as guidelines.

Key Words: Bundle-branch block • Right ventricular hypertrophy • Intraventricular conduction defect