12-lead vectorcardiography in ischemic heart disease

The conventional approach to recording the vectorcardiogram is to use a specially designed set of electrodes that derive 3-orthogonal leads, ideally corrected with respect to lead strength and direction. This has disadvantages in that it entails a separate recording as opposed to the use of the 12-lead ECG that is universally used. On the other hand, recently developed equations allow the vectorcardiogram to be derived from the 12-lead ECG, and although there is not a one-to-one correspondence with the vectorcardiogram derived using a corrected orthogonal lead system, it has been shown that there is a high degree of similarity between the two derivations. This article discusses the advantages of utilizing the "derived 12-lead vectorcardiogram," which is claimed to have information that is complementary to that of the scalar 12-lead ECG display. It is suggested that using the combination of the 12-lead ECG and the vectorcardiogram derived therefrom, provides the optimum approach to ECG interpretation as compared to using either method alone.