The Apexcardiogram in Myocardial Asynergy

The apexcardiogram was analyzed in 41 patients with an altered pattern of left ventricular contraction. Four types were distinguished: type I, an early sustained systolic bulge which occurred in 12 patients, all of whom had large aneurysms and large enddiastolic volumes; type II, a bulge confined to midsystole which occurred in 13 patients, 11 of whom had some form of ventricular asynergy; type III, a late or end-systolic bulge which occurred in 12 patients, seven of whom had ventricular asynergy; type IV, a prominent spike during diastolic filling which occurred in four patients who had large zones of ventricular asynergy.