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The lead as vector: the lead-vector-diagram of unipolar and bipolar leads during shifts of the electrical null point



The lead as vector: the lead-vector-diagram of unipolar and bipolar leads during shifts of the electrical null point



Arch F Kreislaufforsch 19(4/7): 178-203



The view is elaborated that there is a continuous movement, within each heart cycle, of the "null point" and therefore the assumption of a "lead-vector" becomes necessary in lieu of the fixed lead line. The potential of Wilson's central terminal electrode is not equal to zero as the position of the heart is eccentric and a lead vector can be detd. for the Wilson electrode, pointing toward the upper left extremity, as the unipolar left arm lead possesses a greater lead vector. Since the lead vector is constantly changing in magnitude and direction, the "lead-vector-moment" can be followed throughout each cycle. The path followed is called "lead-vector diagram" because the vector-cardiogram is the contour in space of the positions and size of the electrical axis of the heart. In the interpretation of vector-cardiograms the path of the null point has to be taken into consideration. On theoretical grounds, the system of leads with the minimum null point shift, namely bipolar leads with approximately the same electrode distance, is detd.

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