Criteria of systolic(pressure) overloading LVH
I. Voltage criteria
- Limb leads
- Lead I: R > 15 mm or R > 18 mm with left axis deviation (LAD)
- Lead aVL: R > 12 mm or R > 16 mm with LAD
- Lead II or III: R > 25 mm
- Precordial leads
- V5 > 26 mm
- Sum of S wave in V2 and R wave in V5 > 36 mm
- V6 > V5
- Orthogonal leads
- Transverse plane mean QRS vector > 20 mm
- Frontal plane mean QRS vector > 25 mm
II. Secondary ST-T changes
III. Increased QRS duration
- Intrinsicoid deflection > .09 sec
- Incomplete Left Bundle Branch Block (ILBBB)
- Loss of R wave in V1 and V2
IV. P wave abnormality of left atrial enlargement (LAE)
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[EKG Atlas]
