Electrocardiographic study of chronic pulmonary emphysema by means of body surface mapping

In order to investigate the electrocardiographic changes in patients with chronic pulmonary emphysema (CPE), 87 unipolar electrocardiograms were simultaneously recorded in 20 normal subjects and 22 patients with CPE. The voltages and the sites of Max. R (most positive R) and Max. S (most negative S) in these 87 leads were investigated. Further, the voltages and the sites of the maximum and the minimum on isopotential maps during the QRS period were examined. In patients with CPE, the sites of Max. R, Max. S, the maximum and the minimum were all positioned lower than in normal subjects. However, the voltages of Max. R and Max. S in CPE were not significantly different from those in normal subjects. It was considered that the most prominent change in the body surface maps in CPE was the downward shift of potential distribution. This change seems to be due mainly to the downward displacement of the diaphragm and the heart resulting from the overinflation of the lung.