VENTRICULAR PREMATURE BEATS IN THE DIAGNOSIS OF MYOCARDIAL INFARCTION

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Abstract
Experimental and clinical studies on the significance of ventricular premature beats in the diagnosis of myocardial infarction are reported. The unipolar patterns of VPB, that are diagnostic of myocardial infarction are of the QR type (Qr, Qrs, and Qrs complexes). The post-mortem studies revealed that the inter-ventricular system was always involved. The conclusion is reached that any ectopic beat with aberrant conduction, irrespective of its site of origin (right or left ventricle, ventricular or supraventricular), is diagnostic of myocardial infarction when the ectopic beat presents a QR type of morphology in leads reflecting the potential variations of the ventricles. A comparison of the diagnostic value of ectopic beats and sinus beats with normal conduction, can be summarized according to the three main possibilities, thus (1) the infarction may be diagnosed from the sinus beats as well as from the ectopic beats; (2) the infarction may be diagnosed from the sinus beats and from the ectopic beats, but the latter are of greater value in defining its localization and extent; or (3) the infarction may be diagnosed only by the patterns of the ectopic beats and not by those of the sinus beats.