May 1958

Use of a Single-Lead ECG in the Detection of Congenital Heart Disease

Author Affiliations

From the Denver Rheumatic Fever Diagnostic Service and the University of Colorado School of Medicine. Dr. Morton is with the Heart Disease Control Program of the U. S. Public Health Service, assigned to the Colorado State Department of Public Health; Dr. Lloyd is Chief of the Durango Heart Clinic; Dr. Dodge was formerly Acting Head of the Department of Preventive Medicine, University of Colorado, and is presently with the School of Public Health, University of Michigan; Dr. Hoffman was formerly Director of the Denver Rheumatic Fever Diagnostic Service and presently is Chief of Cardiology, National Jewish Hospital, Denver.

AMA Am J Dis Child. 1958;95(5):492-497. doi:10.1001/archpedi.1958.02060050496006

This study was undertaken in an attempt to investigate the hypothesis that a single-lead electrocardiogram taken from the right precordium (V3R) on a mass survey basis could detect a large proportion of operable congenital heart defects associated with right ventricular hypertrophy (RVH). These defects would include atrial septal defect, pulmonic stenosis, tetralogy of Fallot, "atypical" patent ductus arteriosus, and some varieties of ventricular septal defect.

The V3R lead was chosen as the single lead for study in accord with the findings of Sokolow and Lyon8 and of Katz et al.,2 who have demonstrated that right precordial leads seem to be the most sensitive indicators of RVH. Single leads have been used previously on ECG mass surveys.4 The single lead used has generally been standard Lead I and has been shown to be a rather poor indicator of heart disease when used as a

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