For the same reason, R-wave peak time may also be prolonged. Prolonged QRS duration - Because it takes a longer time to depolarize a larger myocardial mass, the QRS duration may be slightly prolonged.The ST segment is typically slightly concave (Figures 1 and 2). Secondary ST-T changes in right sided leads - ST segment elevation is common in leads V1 and V2.Therefore, the term secondary ST-T changes should be preferred. However, this term is not in use anymore because it has been shown that such ECG changes also occur in conditions where the left ventricle is not overloaded (e.g dilated cardiomyopathy, hypertrophic cardiomyopathy). These ECG changes were previously referred to as strain pattern, because it was believed that it indicated left ventricular exhaustion. It is typical that the ST-segment bulges upwards (Figure 1 and 2) in these leads. Secondary ST-T changes in left sided leads - Left ventricular hypertrophy is often accompanied by J point depression, downsloping ST segment and inverted (asymmetric) T-waves i the left sided leads.Large R-waves in left sided leads (V5, V6, I and aVL) and deep S-waves in right sided leads (V1, V2) indicate that the vector of the left ventricle is amplified.Romhilt-Este's score system ECG changes in left ventricular hypertrophy (LVH) V1-V2 (right ventricle): ≥35 milliseconds Romhilt-Este's score systemĭiscordant ST-T change in a patient not on digoxin treatmentĭiscordant ST-T change in a patient on digoxin treatment

Romhilt-Este's index, which is point-based, has been reported to have a sensitivity of 60%. Sensitivity 42%, specificity 95% Cornell product criteria Sokolow-Lyon's index is the most used index, despite having the lowest sensitivity (20%) of all indexes. ECG citeria/index for left ventricular hypertrophy (LVH) Sokolow-Lyon criteria Two ECGs showing left and right ventricular hypertrophy.

Example ecg tracing of ivcd