VECTORIAL ANALYSIS OF THE ELECTROCARDIOGRAM IN COMMON VENTRICLE

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Abstract
The electrocardiograms in 21 cases of common ventricle with transposition of the great vessels were analyzed vectorially. Anatomically, cases differed with respect to the position of the infundibular chamber, and anatomical status of the pulmonary and A-V valves. Intact A-V valves were present in 15 cases, common A-V valve in 3, tricuspid atresia in 2, and mitral atresia in one. Obstruction to pulmonary flow was present in 9 cases. The infundibular chamber was located at the right aspect of the base of the heart (non-inversion of the infundibulum) in 11 cases, and at the left aspect of the base of the heart (inversion of the infundibulum) in 10 cases. In the cases analyzed there was no specific pattern that would indicate (1) the association with common ventricle of an anomaly of the atrio-ventricular valvular mechanism, (2) pulmonary stenosis, or (3) the presence of an inverted infundibular chamber. Three electrocardiographic abnormalities were frequently observed in the material studied: (1) deviation from the anticipated normal of the initial vectors in 20 of the 21 cases; (2) stereotyped complexes in all prae-cordial leads (rS, QRs, or RS patterns) in 9 cases; and (3) discordancy of the mean QRS vectors between the frontal and the horizontal projections in 5 cases. The abnormalities given may also be noted in other conditions with congenital displacement of the major conduction system. These include congenitally corrected transposition and anomalies of the "A-V commune" type.