THE ELECTROCARDIOGRAM IN THE TETRALOGY OF FALLOT

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Abstract
Ecg. findings in 52 cases of tetralogy of Fallot revealed abnormally tall pointed P waves in 35%, evidence of marked right axis deviation in both standard or unipolar limb leads in 98%, aVR showed a prominent R in 68%, duration of QRS normal in 96%. There were 2 cases of incomplete, but no case of complete right bundle branch block. The most characteristic finding was in V1 with a reversal of the R/S ratio in 98%, delay in the intrinsic deflection (94%) and an abnormal differential index between the intrinsic deflections of V and V1 (96%). S was prominent in the left chest leads. A qR pattern in V1 was uncommon (15%) and was regarded as evidence of severe right ventricular hypertrophy. There were no striking changes in the ecg. taken before and after operation, except for coronary T wave changes in cases having a direct ventricular operative approach.