title: ECG leads I and II to evaluate diuresis of patients with congestive heart failure admitted to the hospital via the emergency department.
abstract: BACKGROUND
  Attenuation of electrocardiogram (ECG) QRS complexes is observed in patients with a variety of illnesses and peripheral edema (PERED), and augmentation with alleviation of PERED. Serial ECGs in stable individuals display variation in the amplitude of QRS complexes in leads V1-V6, stemming from careless placement of recording electrodes on the chestwall. Electrocardiographs record only leads I and II, and mathematically derive the other four limb leads in real time. This study evaluated the sum of the amplitudes of ECG leads I and II, along with other sets of ECG leads in the monitoring of diuresis in patients with congestive heart failure (CHF).
  
  
  METHODS
  Twenty patients with CHF had ECGs and weights recorded on admission and at discharge. The amplitude of the QRS complexes in all ECG leads were measured and sums of I and II, all limb leads, V1-V6, and all 12 leads were calculated.
  
  
  RESULTS
  There was a good correlation between the weight loss and the increase in the sums of the amplitudes of the QRS complexes from leads I and II (r = 0.55, P = 0.012), and the six limb leads (r = 0.68, P = 0.001), but a poor correlation with the V1-V6 leads (r = 0.04, P = 0.85) and all 12 leads (r = 0.1, P = 0.40).
  
  
  CONCLUSIONS
  Sums of the amplitudes of the ECG QRS complexes from leads I and II constitute a reliable, easily obtainable, ubiquitously available, bedside clinical index, which can be employed in the diagnosis, monitoring of management, and follow-up of patients with CHF.
authors.affiliation: Faculty of Medicine of Chiang Mai University, Emergency Unit of Maharat Nakorn Chiangmai Hospital, Chiang Mai, Thailand.
authors.forename: Suthaporn
authors.initials: S
authors.lastname: Lumlertgul
authors.forename: Boriboon
authors.initials: B
authors.lastname: Chenthanakij
authors.forename: John E
authors.initials: JE
authors.lastname: Madias
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004231:Diuresis; D004232:Diuretics / Q000008:administration & dosage*; D004562:Electrocardiography / Q000295:instrumentation* / Q000379:methods / Q000706:statistics & numerical data*; D004566:Electrodes / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D004232:Diuretics