ECG leads I and II to evaluate diuresis of patients with congestive heart failure admitted to the hospital via the Emergency Department

Suthaporn Lumlertgul, Boriboon Chenthanakij, John E. Madias

Research output: Contribution to journalArticlepeer-review

18 Scopus citations

Abstract

Background: Attenuation of electrocardiogram (ECG) QRS complexes is observed in patients with a variety of illnesses and peripheral edema (PERED), and augmentation with alleviation of PERED. Serial ECGs in stable individuals display variation in the amplitude of QRS complexes in leads V1-V6, stemming from careless placement of recording electrodes on the chestwall. Electrocardiographs record only leads I and II, and mathematically derive the other four limb leads in real time. This study evaluated the sum of the amplitudes of ECG leads I and II, along with other sets of ECG leads in the monitoring of diuresis in patients with congestive heart failure (CHF). Methods: Twenty patients with CHF had ECGs and weights recorded on admission and at discharge. The amplitude of the QRS complexes in all ECG leads were measured and sums of I and II, all limb leads, V1-V6, and all 12 leads were calculated. Results: There was a good correlation between the weight loss and the increase in the sums of the amplitudes of the QRS complexes from leads I and II (r = 0.55, P = 0.012), and the six limb leads (r = 0.68, P = 0.001), but a poor correlation with the V1-V6 leads (r = 0.04, P = 0.85) and all 12 leads (r = 0.1, P = 0.40). Conclusions: Sums of the amplitudes of the ECG QRS complexes from leads I and II constitute a reliable, easily obtainable, ubiquitously available, bedside clinical index, which can be employed in the diagnosis, monitoring of management, and follow-up of patients with CHF.

Original languageEnglish
Pages (from-to)64-71
Number of pages8
JournalPACE - Pacing and Clinical Electrophysiology
Volume32
Issue number1
DOIs
StatePublished - Jan 2009
Externally publishedYes

Keywords

  • Biomedical engineering
  • Congestive heart failure
  • Echocardiography
  • Electrocardiogram
  • Electrophysiology - clinical

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