The ECG pp 541-560 | Cite as

Special ECG Waves, Signs and Phenomena

  • Marc Gertsch


This chapter was designed to illustrate that there are still some clinically relevant ECG signs or phenomena that are often connected with the names of their ‘inventors’, while others are only of historical interest (or are ridiculous). It is likely that readers of both sections will be interested in this subject. The ‘special waves’ are listed in alphabetical order.


Ventricular Fibrillation Brugada Syndrome Ventricular Premature Beat Delta Wave Early Repolarization 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Lewis T. Paroxysmal tachycardia, the result of ectopic impulse formation, Heart 1910;1:262–82Google Scholar
  2. 2.
    Gouaux IL, Ashman R. Auricular fibrillation with aberration simulating paroxysmal tachycardia. Am Heart J 1947;34:366PubMedCrossRefGoogle Scholar
  3. 3.
    Chaudry II, Ramsaran EK, Spodick DH. Observations on the reliability of the Ashman phenomenon. Review. Am Heart J 1994;128:205–9CrossRefGoogle Scholar
  4. 4.
    Akiyama T, Richeson JF, Faillace RT, et al. Ashman phenomenon of the T wave. Am J Cardiol 1989;63:886–90PubMedCrossRefGoogle Scholar
  5. 5.
    Osher HL, Wolff L. Electrocardiographic pattern simulating acute myocardial injury. Am J Med Sci 1953;226:541–5PubMedGoogle Scholar
  6. 6.
    Edeiken J. Elevation of the RS-T segment, apparent or real, in the right precordial leads as a probable normal variant. American Heart J 1954;38:331CrossRefGoogle Scholar
  7. 7.
    Brugada P, Brugada J. Right bundle-branch block, persistent ST segment elevation and sudden cardiac death: a distinct clinical and electrocardiographic syndrome. A multicenter report. J Am Coll Cardiol 1992;20:1391–6PubMedCrossRefGoogle Scholar
  8. 8.
    Brugada P, Brugada R, Brugada J. Sudden death in patients and relatives with the syndrome of right bundle-branch block, ST segment elevation in the precordial leads V(1) to V(3) and sudden death. Europ Heart J 2000;21:321–6CrossRefGoogle Scholar
  9. 9.
    Viskin S, Fish R, Eldar M, et al. Prevalence of the Brugada sign in idiopathic ventricular fibrillation and healthy controls. Heart 2000;84:31–6PubMedCrossRefGoogle Scholar
  10. 10.
    Bolognesi R, Tsialtas D, Vasini P, et al. Abnormal ventricular repolarization mimicking myocardial infarction after here-rocyclic antidepressant overdose. Am J Cardiol 1997;79:242–5PubMedCrossRefGoogle Scholar
  11. 11.
    Goldgrand-Toledano D, Sideris G, Kevorkian J-P. Overdose of cyclic antidepressants and the Brugada syndrome. N Engl J Med 2002;346:1591–2CrossRefGoogle Scholar
  12. 12.
    Rouleau F, Asfar P, Boulet S, et al. Transient ST segment elevation in right precordial leads induced by psychotropic drugs: relationship to the Brugada syndrome. J Cardiovasc Electrophysiol 2001;12:61–5PubMedCrossRefGoogle Scholar
  13. 13.
    Sangwatanaroy S, Prechawat S, Sunsaneewitayakul B, et al. New electrocardiographic leads and the procainamide test in the detection of the Brugada sign in sudden unexplained death syndrome survivors and their relatives. Europ Heart J 2001;22:2290–6CrossRefGoogle Scholar
  14. 14.
    Brugada P, Brugada J, Brugada R. Dealing with biological variation in the Brugada syndrome (editorial). Europ Heart J 2001;22:2231–2CrossRefGoogle Scholar
  15. 15.
    Wilde AAM, Antzelevitch C, Borggrefe M, et al. Proposed diagnostic criteria for the Brugada syndrome. Consensus report. Europ Heart J 2002;23:1648–54Google Scholar
  16. 16.
    Cabrera E, Friedland C. LA onda de activaciòn ventricular en el bloqueo de rama isquierda con infarto: un nuevo signo electrocardiografico. Arch Inst Cardiol Mex 1953;23:441–60PubMedGoogle Scholar
  17. 17.
    Chatterjee K, Harris AM, Davies JG, Leatham A. T-wave changes after artificial pacing (preliminary communication). Lancet 1979;1(7598):759–6oGoogle Scholar
  18. 18.
    Chatterjee K, Harris AM, Davies JG, Leatham A. Electrocardiographic changes subsequent to artificial ventricular depolarization. Br Heart J 1979;31:770–9CrossRefGoogle Scholar
  19. 19.
    Alessandrini RS, McPherson DD, Kadish AH, et al. Cardiac memory: a mechanical and electrical phenomenon. Am J Physiol 1997;272:1952–9Google Scholar
  20. 20.
    Wilson FN. A case in which the vagus influenced the form of the ventricular complex of the electrocardiogram. Arch Intern Med 1915;16:1008–27CrossRefGoogle Scholar
  21. 21.
    Wolff L, Parkinson J, White PD. Bundle-branch block with the short P-R interval in healthy young people prone to paroxysmal tachycardia. Am Heart J 1930;5:685–704CrossRefGoogle Scholar
  22. 22.
    Segers PM, Lequime J, Denolin H. L’activation ventriculaire précoce de certains coeurs hyperexitables: étude de l’onde 6 de l’électrocardiogramme. Cardiologia 1944;8:113–67CrossRefGoogle Scholar
  23. 23.
    Dressler W, Roesler H. The occurrence in paroxysmal ventricular tachycardia of ventricular complexes transitional in shape to sino-auricular beats. Am Heart J 1952;44:485–93PubMedCrossRefGoogle Scholar
  24. 24.
    Young RL, Mower MM, Ramapuram GM, et al. Atrial fibrillation with ventricular tachycardia showing “Dressier” beats. Chest 1973;63:96–7PubMedCrossRefGoogle Scholar
  25. 25.
    Fontaine G, Guiraudon, Frank R, et al. Stimulation studies and epicardial mapping in ventricular tachycardia: study of mechanism and selection for surgery. In: Kulbertus HE (ed). Re-Entrant Arrhythmias: Mechanisms and Treatment. Lancaster PA: MTP Publishers 1977, pp 334–50Google Scholar
  26. 26.
    Jaoude SA, Leclercq JF, Coumel P. Progressive ECG changes in arrhythmogenic right ventricular diseases. Evidence for an evolving disease. Eur Heart J 1996;17:1717–21PubMedCrossRefGoogle Scholar
  27. 27.
    Fontaine G, Gallais J, Fornesd P, et al. Arrhythmogenic right ventricular dysplasia/cardiomyopathy. Anaesthesiology 2001;95:250–4CrossRefGoogle Scholar
  28. 28.
    Gemayel C, Pelliccia A, Thompson PD. Arrhythmogenic right ventricular cardiomyopathy. J Am Coll Cardiol 2001;38:1773–81PubMedCrossRefGoogle Scholar
  29. 29.
    Marcus FI. Update of arrhythmogenic right ventricular dysplasia. Card Electrophysiol Rev 2002;6:54–6PubMedCrossRefGoogle Scholar
  30. 30.
    McGinn S, White PD. Acute cor pulmonale resulting from pulmonary embolism. Its clinical recognition. J Amer Med Assoc 1935;104:1473–80CrossRefGoogle Scholar
  31. 31.
    Katz LN, Wachtel H. The diphasic QRS type of electrocardiogram in congenital heart disease. Am Heart J 1937;13:202–6CrossRefGoogle Scholar
  32. 32.
    Osborn JJ. Experimental hypothermia: Respiratory and blood Ph changes in relation to cardiac function. Am J Physiol 1953;175:389–98PubMedGoogle Scholar
  33. 33.
    Vassallo SU, Delaney KA, Hoffman RS, et al. A prospective evaluation of the electrocardiographic manifestations of hypothermia. Acad Emerg Med 1999;6:1121–6PubMedCrossRefGoogle Scholar
  34. 34.
    Patel A, Getsos JP, Moussa G, Damato AN. The Osborn wave of hypothermia in normothermic patients. Clin Cardiol 1994;17:273–6PubMedCrossRefGoogle Scholar
  35. 35.
    Martinez Martinez JA. Postoperative pericarditis and Osborn wave. Medicina (B Aires) 1998;58:428Google Scholar
  36. 36.
    Abbott JA. The nonspecific camel-hump sign. J Amer Med Assoc 1976;235:413–4CrossRefGoogle Scholar
  37. 37.
    Kalla H, Yan GX, Marinchak R. Ventricular fibrillation in a patient with prominent J (Osborn) waves and ST segment elevation in the inferior electrocardiographic leads: a Brugada syndrome variant? J Cardiovasc Electrophysiol 2000;11:95–8PubMedCrossRefGoogle Scholar
  38. 38.
    Yan GX, Antzelevitch C. Cellular basis for the electrocardiographic J wave. Circulation 1996;93:372–9CrossRefGoogle Scholar
  39. 39.
    Pardee HEB. Clinical Aspects of the Electrocardiogram. London: Lewis 1941Google Scholar
  40. 40.
    Lown B, Wolf M. Approaches to sudden death by coronary heart disease. Circulation 1971;44:130–42PubMedCrossRefGoogle Scholar
  41. 41.
    El-Sherif N, Myerburg RJ, Scherlag BJ, et al. Electrocardiographic antecedents of primary ventricular fibrillation. Value of the R-on-T phenomenon in myocardial infarction. Br Heart J 1976;38:415–22PubMedCrossRefGoogle Scholar
  42. 42.
    Engel TR, Meister SG, Frankl WS. The ‘R-on-T’ phenomenon. An update and critical review. Ann Intern Med 1978;88:221–5PubMedCrossRefGoogle Scholar
  43. 43.
    Chou TC, Wenzke F. The importance of R-on-T phenomenon. Am Heart J 1978;96:191–4PubMedCrossRefGoogle Scholar
  44. 44.
    Chiladakis JA, Karapanos G, Davlouros P, et al. Significance of R-on-T phenomenon in early ventricular tachyarrhythmia susceptibility after acute myocardial infarction in the thrombolytic era. Am J Cardiol 2000;85:289–93PubMedCrossRefGoogle Scholar
  45. 45.
    Braunwald E (ed). Heart Disease. A Textbook of Cardiovascular Medicine, 5th edn. Philadelphia: WB Saunders 1997Google Scholar
  46. 46.
    Rodstein M, Wolloch L, Gubner RS. Mortality study of the significance of extrasystoles in an insured population. Circulation 1971;44:617–25PubMedCrossRefGoogle Scholar
  47. 47.
    Von Olshausen K, Treese N, Pop T, et al. Plötzlicher Herztod im Langzeit-EKG. Deutsch med Wochenschr 1985;110:1195–201CrossRefGoogle Scholar
  48. 48.
    Tye KH, Samant A, Desser KB, Benchimol A. R-on-T or R on P phenomenon? Relation to the genesis of ventricular tachycardia. Am J Cardiol 1979;44:632–7PubMedCrossRefGoogle Scholar
  49. 49.
    Hurst JW. Naming of the waves in the ECG, with a brief account of their genesis. Circulation 1998;98:1937–42PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2004

Authors and Affiliations

  • Marc Gertsch
    • 1
  1. 1.Department of Cardiology, Swiss Cardiovascular Center BernUniversity Clinic InselspitalBernSwitzerland

Personalised recommendations