[Additional right pectoral leads]

A total of 476 subjects were examined. The control group was of 220 (170 healthy males and 50 females) and 256 cardiac patients (180 males and 76 females); with right ventricle loading -- 106 (6-70 years), left ventricle - 35 (average age 38), disturbed intraventricular conductivity -- 76, and myocardial infarction -- 39 patients. The additional right pectoral leads (ARPL) -- V3R--V8R are included in the extended ECG programme for investigation (routine 12 ECG leads, left precordial -- V7--V9 and Nehb). In normal cases, the auricular wave P is positive in V3R--V6R, biphasic in V7R--V8R, rarely isoelectric in V8R. The form of ventricular complex in ARPL depends closely on the electric cardiac position. The forms rS are present in horizontal position -- in V3R--V8R; in vertical -- the forms rSin V3R--V5R and qr, Qr in V6R--V8R. In the direction form V3R to V8R, a reduced amplitude of ventricular complex is established. In right ventricular hypertrophy, the characteristic changes in V1--V2 (high R deflection and negative T waves) are more distinctly manifested in V3R--V5R. In advanced cases of chronic pulmonary heart high amplitude qR predominates in V3R--V7R. Contrary to the physiological type syndrome S1S2S3, where no deviations are found in ARPL, in the pathological variety -- pathologically changed ventricular complexes are present. In myocardial infarction of the posterior wall, the presence of high elevation of the segment ST and QS in V3R--V4R is an indication for the involvement of the interventricular septum as well and is a prognostic unfavourable sign.