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STANDARDIZATION OF CHEST LEADS AND THEIR VALUE IN CORONARY THROMBOSIS AND MYOCARDIAL DAMAGE

ARTHUR M. HOFFMAN, M.D.; EVERETT DELONG, M.D.
Arch Intern Med (Chic). 1933;51(6):947-964. doi:10.1001/archinte.1933.00150250131009.
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Interest in the use of chest leads in the diagnosis of coronary thrombosis was stimulated by Wolferth and Wood.1 In a patient with normal standard leads with a clinical picture of coronary thrombosis, they found a striking abnormal deviation of the S-T interval from the isoelectric line in tracings taken with electrodes over the anterior and posterior surfaces of the chest. A second patient showed only a minor deviation from the normal in lead I and a more pronounced deviation in the chest lead, or lead IV. These changes they also found in experimentally produced occlusion of the coronary arteries.2

They state that "if conclusions are to be drawn from minor variations in the contour of the tracings in lead IV, the relation of electrodes to the heart should be kept constant. We paid no attention to minor variations in the position of the electrodes and have not

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