Multiple dipole electrocardiography: a comparison of electrically and angiographically determined left ventricular masses.

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Abstract
In 1969, a new method was published for estimating the mass of electrically active muscle in the left ventricle (electrical LVM). A prospective test of this method, using a series of 113 patients was reported. These patients were believed not to have had myocardial infarctions, so that their electrical LVM should equal their anatomic LVM, which was independently determined from LV biplane angiocardiogram. The correlation coefficient between electrical LVM and angiographic LVM was r = 0.85, and the root mean square deviation of electrical LVM, relative to the angiographic LVM, was 66 g. The electrical LVM estimate had an accuracy of about 1/3 of an average normal LVM. A special case of LVM estimation is the diagnosis of left ventricular hypertrophy (LVH). To test the diagnostic performance of the method, the series was partitioned on the basis of angiographic LVM, into 2 subseries: normal LVM and above normal LVM. These subseries were used for a set of trial diagnoses of LVH by the new method: the specificity was 84% and the sensitivity was 86%. For comparison, trial diagnoses using the Sokolow-Lyon cirterion on the standard 12-lead ECG gave a specificity of 84% and a sensitivity of 50%, and the Romhilt-Estes point-score method gave a specificity of 95% and a sensitivity of 49%. Diagnosis of LVH by this new method is more reliable than by traditional ECG methods.