The Minnesota Code Manual of Electrocardiographic Findings

The electrocardiogram (ECG) is most often used in clinical and hospital settings for diagnosis and prognosis, but it is also used for systematic population studies and clinical trials where a repeatable, valid, and quantitative method is required for clas

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The Minnesota Code Manual of Electrocardiographic Findings including measurement and comparison with the Novacode

Standards and Procedures for ECG Measurement in Epidemiologic and Clinical Trials

Second Edition New and Enlarged

Ronald J. Prineas, MB, BS, PhD Richard S. Crow, MD Zhu-Ming Zhang, MD

Illustrated by Xueling Hu, M.S.

From the EPICARE, Division of Public Health Sciences, Wake Forest University School of Medicine, and The Division of Epidemiology, School of Public Health, University of Minnesota.

Ronald J. Prineas Wake Forest University School of Medicine Winston-Salem, NC USA [email protected]

Richard S. Crow University of Minnesota Minneapolis, MN USA [email protected]

Zhu-Ming Zhang Wake Forest University School of Medicine Winston-Salem, NC USA [email protected]

ISBN 978-1-84882-777-6 e-ISBN 978-1-84882-778-3 DOI 10.1007/978-1-84882-778-3 Springer London Dordrecht Heidelberg New York Library of Congress Control Number: 2009937250 © Springer-Verlag London Limited 2010 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the Copyright, Designs and Patents Act 1988, this publication may only be reproduced, stored or transmitted, in any form or by any means, with the prior permission in writing of the publishers, or in the case of reprographic reproduction in accordance with the terms of licences issued by the Copyright Licensing Agency. Enquiries concerning reproduction outside those terms should be sent to the publishers. The use of registered names, trademarks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant laws and regulations and therefore free for general use. Product liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)

Dedication: To our mentors and colleagues, Henry Blackburn, Pentti Rautaharju, and in memory of Geoffrey Rose

Contents Preface for the second edition ............................................................................................................. ix Preface for the first edition .................................................................................................................. xi Acknowledgments ............................................................................................................................... xiii 1

What is the Electrocardiogram or ECG? ............................................................................................. The Electricity Part of the ECG

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ECG Leads .......................................................................................................................................... Bipolar Limb Leads(I, II, III) / Unipolar Limb Leads(aVR, aVL, aVF) / C