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Article
April 1919

THE CLINICAL SIGNIFICANCE OF SLIGHT NOTCHING OF THE R-WAVE OF THE ELECTROCARDIOGRAM

Author Affiliations

PITTSBURGH

From the Department of Medicine, University of Pittsburgh.

Arch Intern Med (Chic). 1919;23(4):515-526. doi:10.1001/archinte.1919.00090210109009
Abstract

As a result of extensive electrocardiographic studies in past years, the questions of the more common disturbances of the cardiac mechanism have for the time being been settled, and numerous investigators have directed efforts to the elicitation of electrocardiographic evidences of myocardial involvement. Carter1 has summarized the knowledge of the aberrant beat and the electrocardiogram associated with a lesion of either branch of the atrioventricular bundle. The ventricular complex is said to be characterized by a notched or bizzare R-wave of high amplitude, a QRS interval exceeding 0.10 second and an exaggerated T-wave usually opposite to the initial deflection. Such curves are indicative of an extensive pathologic process and imply a grave prognosis. Oppenheimer and Rothschild2 have described intraventricular or arborization block. The underlying pathology of their cases was coronary sclerosis or disseminated patchy sclerosis of the myocardium predominate in the Purkinje network. The electrical curves are of low voltage

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