The Electrocardiogram in Congenital Heart Disease

Adequate unipolar electrocardiograms have been recorded on 101 patients with congenital heart disease and the findings analyzed. It has been found that the chief value of such tracings rests in the determination of ventricular preponderance, the evidence being obtained from study of the QRS complexes in unipolar limb and multiple precordial leads, with relatively little help from the RS-T segments and T waves. Auricular hypertrophy, encountered chiefly in association with pulmonic stenosis and tricuspid valve disease, could be best detected by analysis of P waves seen in the right precordial leads rather than in the limb leads. Intraventricular block was observed both with auricular and with ventricular septal defects, and was also found in Ebstein's disease and with coarctation of the aorta. Auriculoventricular block and arrhythmias were rare.