The anatomic basis for high-frequency components in the electrocardiogram.

In a correlative study between selected body-surface potential recordings and anatomic findings, multilead sets of high-fidelity, high-speed records from 128 persons were studied in connection with the results of our detailed postmortem dissections of their hearts. Attention was focused on high-frequency components (notching and slurring of the expanded QRS) as described by Langner. We found that (1) groups with ventricular enlargement without scarring were indistinguishable from groups with infarction on the basis of the number of highfrequency components; (2) both of these groups were clearly distinguishable from normal subjects on this basis alone; and (3) the high-frequency component count in the group with ventricular enlargement showed high negative correlation with age and high positive correlation with right and left ventricular weights. These findings suggest that the appearance of high-frequency components in the vectorcardiogram or electrocardiogram may relate to the struggle between competing generator sites of ventricular enlargement as well as to the classic concept of shattering of the wave of activation on the shoals of infarction.