Literature DB >> 20522059

Clinical utility of aVR-The neglected electrocardiographic lead.

Dmitriy Kireyev1, Mikhail V Arkhipov, Stephen T Zador, Joseph A Paris, William E Boden.   

Abstract

BACKGROUND: Several studies suggest that electrocardiographers tend to neglect lead aVR during the reading of electrocardiograms (ECGs). Our objective was to provide a systematic review of the most important diagnostic and prognostic uses of lead aVR.
METHODS: We performed a thorough review of the literature about the lead aVR using PubMed, MEDLINE and the archives of the University at Buffalo libraries.
RESULTS: We found that lead aVR may provide important additional information in the diagnosis of coronary artery disease. It may provide a clue to the location of a lesion as well as the possibility of three vessel disease during an acute coronary syndrome. Lead aVR was found useful in the locus of arrhythmias and in differentiation of narrow and wide QRS complex tachycardias. It provides useful prognostic information for patients with the Brugada syndrome and tricyclic antidepressant toxicity. Lead aVR provides alternative criteria for the electrocardiographic diagnosis of left ventricular hypertrophy and left anterior fascicular block.
CONCLUSION: Lead aVR provides very important additional diagnostic and prognostic information in multiple cardiac conditions and can be used either alone or in conjunction with other electrocardiographic leads.

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Year:  2010        PMID: 20522059      PMCID: PMC6932457          DOI: 10.1111/j.1542-474X.2010.00359.x

Source DB:  PubMed          Journal:  Ann Noninvasive Electrocardiol        ISSN: 1082-720X            Impact factor:   1.468


  48 in total

1.  Cardiovascular monitoring of children and adolescents receiving psychotropic drugs: A statement for healthcare professionals from the Committee on Congenital Cardiac Defects, Council on Cardiovascular Disease in the Young, American Heart Association.

Authors:  H Gutgesell; D Atkins; R Barst; M Buck; W Franklin; R Humes; R Ringel; R Shaddy; K A Taubert
Journal:  Circulation       Date:  1999-02-23       Impact factor: 29.690

Review 2.  Broad complex tachycardia--Part I.

Authors:  June Edhouse; Francis Morris
Journal:  BMJ       Date:  2002-03-23

3.  P-wave morphology in focal atrial tachycardia: development of an algorithm to predict the anatomic site of origin.

Authors:  Peter M Kistler; Kurt C Roberts-Thomson; Haris M Haqqani; Simon P Fynn; Suresh Singarayar; Jitendra K Vohra; Joseph B Morton; Paul B Sparks; Jonathan M Kalman
Journal:  J Am Coll Cardiol       Date:  2006-08-17       Impact factor: 24.094

4.  Exercise-induced ST-segment elevation in leads aVR and V1 for the prediction of left main disease.

Authors:  M Tuna Katircibaşi; H Tolga Koçum; Abdullah Tekin; Tansel Erol; Göknur Tekin; Mehmet Baltali; Haldun Müderrisoğlu
Journal:  Int J Cardiol       Date:  2007-07-20       Impact factor: 4.164

5.  Simple electrocardiographic criteria for identifying the site of origin of focal right atrial tachycardia.

Authors:  H Tada; A Nogami; S Naito; M Suguta; M Nakatsugawa; Y Horie; T Tomita; H Hoshizaki; S Oshima; K Taniguchi
Journal:  Pacing Clin Electrophysiol       Date:  1998-11       Impact factor: 1.976

6.  The standard 11-lead ECG. Neglect of lead aVR in the classical limb lead display.

Authors:  U S Pahlm; O Pahlm; G S Wagner
Journal:  J Electrocardiol       Date:  1996       Impact factor: 1.438

7.  Significance of exercise-induced simultaneous ST-segment changes in lead aVR and V5.

Authors:  A P Michaelides; Z D Psomadaki; D J Richter; P E Dilaveris; G K Andrikopoulos; C Stefanadis; J E Gialafos; P K Toutouzas
Journal:  Int J Cardiol       Date:  1999-09-30       Impact factor: 4.164

8.  ST segment elevation in lead aVR and coronary artery lesions in patients with acute coronary syndrome.

Authors:  Paweł Rostoff; Wiesława Piwowarska
Journal:  Kardiol Pol       Date:  2006-01       Impact factor: 3.108

9.  Significance of exercise-induced ST changes in leads aVR, V5, and V1. Discrimination of patients with single- or multivessel coronary artery disease.

Authors:  Andreas P Michaelides; Zoi D Psomadaki; Maria-Niki K Aigyptiadou; Dimitris J Richter; George K Andrikopoulos; Polychronis E Dilaveris; Konstantinos Tsioufis; Dimitris Tousoulis; Christodoulos Stefanadis; Pavlos K Toutouzas
Journal:  Clin Cardiol       Date:  2003-05       Impact factor: 2.882

10.  Transient ST-segment elevation in lead aVR associated with tako-tsubo cardiomyopathy.

Authors:  Pawel Rostoff; Pawel Latacz; Wieslawa Piwowarska; Ewa Konduracka; Agnieszka Bolech; Krzysztof Zmudka
Journal:  Int J Cardiol       Date:  2008-04-18       Impact factor: 4.164

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  11 in total

1.  Recommendation for revision of the standard presentation of the frontal plane ECG leads including reversal of lead aVR (to -aVR): It is time for a change.

Authors:  Robert B Case; Arthur J Moss
Journal:  Ann Noninvasive Electrocardiol       Date:  2010-04       Impact factor: 1.468

2.  T wave positivity in lead aVR is associated with mortality in patients with cardiac resynchronization therapy.

Authors:  Yahya Kemal İçen; Yurdaer Dönmez; Hasan Koca; Mehmet Uğurlu; Mevlüt Koç
Journal:  J Interv Card Electrophysiol       Date:  2018-04-08       Impact factor: 1.900

3.  Prognostic significance of T-wave amplitude in lead aVR in heart failure patients with narrow QRS complexes.

Authors:  Kentarou Okuda; Eiichi Watanabe; Kan Sano; Tomoharu Arakawa; Mayumi Yamamoto; Yoshihiro Sobue; Tatsushi Uchiyama; Yukio Ozaki
Journal:  Ann Noninvasive Electrocardiol       Date:  2011-07       Impact factor: 1.468

Review 4.  Clinical value of lead aVR.

Authors:  Andrés Ricardo Pérez Riera; Celso Ferreira; Celso Ferreira Filho; Sergio Dubner; Raimundo Barbosa Barros; Francisco Femenía; Adrian Baranchuk
Journal:  Ann Noninvasive Electrocardiol       Date:  2011-07       Impact factor: 1.468

5.  Impact of T wave amplitude in lead aVR on predicting cardiac events in ischemic and nonischemic cardiomyopathy patients with an implantable cardioverter defibrillator.

Authors:  Yoshihiro Tanaka; Tetsuo Konno; Yudai Tamura; Toyonobu Tsuda; Hiroshi Furusho; Masayuki Takamura; Kenji Sakata; Masakazu Yamagishi; Kenshi Hayashi
Journal:  Ann Noninvasive Electrocardiol       Date:  2017-04-25       Impact factor: 1.468

6.  Value of ST-segment change in lead aVR in diagnosing left main disease in Non-ST-elevation acute coronary syndrome-A meta-analysis.

Authors:  Gien-Kuo Lee; Yen-Ping Hsieh; Shang-Wei Hsu; Shou-Jen Lan; Kshitij Soni
Journal:  Ann Noninvasive Electrocardiol       Date:  2019-09-18       Impact factor: 1.468

Review 7.  Pitfalls in Electrocardiographic Diagnosis of Acute Coronary Syndrome in Low-Risk Chest Pain.

Authors:  Semhar Z Tewelde; Amal Mattu; William J Brady
Journal:  West J Emerg Med       Date:  2017-04-17

8.  Importance of lead aVR on predicting adverse cardiac events in patients with noncompaction cardiomyopathy.

Authors:  Firdevs Aysenur Ekizler; Serkan Cay; Nedret Ulvan; Bahar Tekin Tak; Elif Hande Ozcan Cetin; Habibe Kafes; Ozcan Ozeke; Firat Ozcan; Serkan Topaloglu; Omac Tufekcioglu; Dursun Aras
Journal:  Ann Noninvasive Electrocardiol       Date:  2019-10-14       Impact factor: 1.468

9.  ST Segment Elevation in aVR: Clinical Significance in Acute Coronary Syndrome.

Authors:  Antoine Kossaify
Journal:  Clin Med Insights Case Rep       Date:  2013-03-21

10.  ST segment change and T wave amplitude ratio in lead aVR associated with coronary artery disease severity in patients with non-ST elevation myocardial infarction: A retrospective study.

Authors:  Yahya Kemal İçen; Mevlüt Koç
Journal:  Medicine (Baltimore)       Date:  2017-12       Impact factor: 1.817

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