VECTORCARDIOGRAPHY (VCG)

Vectorcardiography is the technique of analyzing the electrical activity of the heart by

obtaining ECG’s along three axes at right angles to one another and displaying any two
of these ECGs as a vector display on an X-Y oscilloscope. The display is known as a
vectorcardiogram (VCG). In contrast, the electrocardiogram which displays the
electrical potential in any one single axis, the vectorcardiogram displays the same
electrical events simultaneously in two perpendicular axes. This gives a vectorial
representation of the distribution of electrical potentials generated by the heart, and
produces loop type patterns (Fig. 5.8) on the CRT screen. Usually a photograph is taken
of each cardiac cycle. From such pictures, the magnitude and orientation of the P, Q,
R, S andT vector loops are determined.

VCG illustrates the phase differences between the voltages and also the various
leads from which it is derived. The major information that it provides is the direction of
depolarization and repolarization oftheatria and theventricles. Each vectorcardiogram
exhibits threeloops, showing the vector orientation of the P wave, the QRS axis and the
T wave. Because of the high amplitude associated with QRS, loops from the QRS
complex predominate. An increase in horizontal and vertical deflection sensitivities is
normally required to adequately display the loops resulting from the P wave and T
wave. Bourne (1974) describes circuit details of an automated vector ECG recording
system.
The VCG has been demonstrated to be superior to the standard 12-lead scalar
electrocardiogram in the recognition of undetected atrial and ventricular hypertrophy,
sensitivity in identification of myocardial infarction and capability for diagnosis of
multiple infarctions in the presence of fascicular and bundle branch blocks
(Benchimol and Desser, 1975).