Clinical Implications of Low-voltage Electrocardiogram
Abstract
Low-voltage on the surface electrocardiogram (ECG) is classically defined as peak-to-peak QRS voltage less than 5 mm in all limb leads and less than 10 mm in all precordial leads. There are many causes of low QRS voltage (LQRSV), and they can be differentiated into those due to the deficient heart’s generated potentials (cardiac causes) and those due to the attenuating influences of the pericardial space and pericardium, or the passive body volume conductor, enveloping the heart (extracardiac causes). In some patients, LQRSV voltage may only represent a normal variant. The ECG challenge for this issue is to examine the physiological, anatomical and electrical equipment problems of low-voltage, or low-amplitude, ECG and to suggest methods for troubleshooting the low-voltage ECG to ensure reliable cardiac monitoring.Downloads
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References
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2. Hannibal G. Interpretatiton of the low-voltage ECG. AACN Advanced Critical Care. 2014;25(number 1):84-8.
3. Madias J. Low QRS voltage and its causes. Journal of Electrocardiology. 2008;41:498-500.
4. Chinitz JS, Cooper JM, Verdino RJ. Electrocardiogram voltage discordance: Interpretation of low QRS voltage only in the limb leads. Journal of Electrocardiology. 2008;41:281-6.
5. Klein I, Danzi S. Thyroid disease and the heart. Circulation. 2007;116:1725-35.
6. Kabadi UM, Kumar SP. Pericardial effusion in primary hypothyroidism. American Heart Journal. 1990 Dec;120(6 Pt
1):1393-5.
7. Madias J. Low-voltage ECG in myocarditis: peripheral edema as a plausible contributing mechanism. PACE. 2007;30:448-52.
8. Falk RH. Diagnosis and management of the cardiac amyloidosis.Circulation. 2005;112:2047-60.
9. Mussinelli R, Salinaro F, Alogna A, et al. Diagnostic and prognostic value of low QRS voltages in cardiac AL amyloidosis.Ann Noninvasive Electrocardiology. 2013;18(3):271-80.
10. Tan NS, Goodman SG, Yan RT, et al. Prognostic significance of low QRS voltage on the admission electrocardiogram in acute coronary syndrome. International Journal of Cardiology. 2015;190:34-9.
11. Japp AG, Gulati A, Cook SA, et al. Diagnosis and evaluation of dilated cardiomyopathy. Journal of the American College of Cardiology. 2016;67:2996-3010.
12. Sisakian H. Cardiomyopathies: Evolution of pathogenesis concepts and potential for new therapies. World Journal of Cardiology. 2014;6(6):478-94.
13. Rahman A, Liu D. Pericarditis: Clinical features and management.Australian Family Physician. 2011;40:791-6.
14. Ozkanlar Y, NishijimaY, Cunha D, et al. A clinical application of the “Brody Effect”. Heart Research Open Journal.2015;2(3):95-9.
Published
2017-04-18
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How to Cite
Andrianto, A., & Dewi, P. (2017). Clinical Implications of Low-voltage Electrocardiogram. Indonesian Journal of Cardiology, 37(4), 206-12. https://doi.org/10.30701/ijc.v37i4.585
Section
Review Article
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