Quantification of the Frank and McFee-Parungao orthogonal electrocardiogram in valvular pulmonic stenosis. Correlations with hemodynamic measurement.

In 66 patients with congenital valvular pulmonic stenosis and intact ventricular septum, correlations were obtined among various multiple hemodynamic and orthogonal vectorcardiographic parameters. The Frank and McFee-parungao lead systems were used. The most important hemodynamic parameter evaluated was right ventricular pressure (RVP). RVP correlated best with X terminal to the right (XTR) in both Frank (R = 0.68) and McFee (R = 0.61) systems. The correlation between RVP and Z anterior was poor. The direction of the initial QRS vector on the X axis was helpful in predicting severity. With X initial to the right, especially in McFee, the RVP is most likely to be systemic or less, while with X initial to the left, the RVP is frequently but not necessarily suprasystemic. T vector spatial orientation is not helpful in the assessment of severity.