Relationship among electrocardiographic potential amplitude, weight, and resistance/reactance/impedance in a patient...

We are presenting a 79-year-old woman with congestive heart failure (CHF) and marked peripheral edema, who responded to medical management by losing 19.7% of her weight. The patient was studied with daily weights, 12-lead electrocardiograms (ECGs), and body electrical resistance/reactance/impedance (R/R/I) measurements via electrodes applied on her hand and foot. In the process she showed a gradual increase in the QRS complexes in her daily ECGs pari passu with the weight loss, leading to a 27.4% increase in the sums of the QRS complexes from the 12 ECG leads ( summation operator SQRS). In addition the patient revealed excellent correlations between weights and summation operator SQRS (r = -.91, P =.013), weights and resistance (r = -.95, P =.004), reactance (r = -.86, P =.029), and impedance (r = -.95, P =.004). Other ECG sets including fewer leads were also employed and correlated with weights and the body electrical properties. It is concluded that loss of peripheral edema in patients with CHF is associated with augmentation of body R/R/I leading to augmented ECG QRS complexes. These findings link etiologically changes of ECG potentials to alteration of body electrical properties, and suggest that serial ECGs could be used in the monitoring of therapy of patients with CHF.