부산대학교 도서관

The previously limited dipole or vector concept in electrocardiography may now be extended to the multipole concept, and the extraction of otherwise lost surface reflections of myocardial electrical activity may now be obtained. The geometric form and orientation for each of the 15 components of a three-stage multipole located at the heart's center have been characterized. This permitted determination of the patterns of potential distribution on the chest resulting from the activation of each of the respective components. The 15 leads have been employed to determine dipolar-quadripolar-octapolar moment of instantaneous body surface potentials, first calculated from a 20-dipole model of ventricular depolarization and, second, actually recorded from normal human subjects. The new information in the quadripolar and octapolar leads appears related both to the anatomic displacement of the mean heart vector and to the estimate of opposed simultaneous electrical forces in the myocardium which ordinarily average or “cancel out” in conventional electrocardiographic and vectorcardiographic leads and thus go unreported. Octapolar strength was found to be greatest in mid-QRS in normal subjects but less than quadripolar in early and late QRS. The quadripolar strength remained approximately one-half that of the dipole or heart vector throughout the heart cycle.