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LVH

R V6

R V5

S V1

R aVL

S V3

R V4

S V2

S III

R I

S V4

The LVH criteria are valid for individuals aged 35 and older.

Sokolow Lyon  (sensitivity 17% specificity 98%)

SV1 + RV5 or V6 > 3.5 mV

or

RaVL > 1.1 mV

Cornell criteria (sensitivity 35%, specificity 92%)

RaVL + SV3 > 2.8 mV in men

or

RaVL + SV3 > 2.0 mV in women

Framingham criteria

R aVL > 1.1 mV, R V4-6 > 2.5 mV

S V1-3 > 2.5 mV, S V1 or V2 + R V5 or V6 > 3.5 mV

R I + S III > 2.5 mV

Romhilt-Estes criteria

Amplitude (Any o f the following)
ST depression or T wave inversions in lateral precordial leads, I and/or aVL
Left atrial enlargement
Left axis deviation
QRS duration ≥ 90 ms
Intrinsicoid deflection in V5 or V6 ≥ 50 ms.
Romhilt-Estes
0

LVH unlikely

LVH present

Peguero-Lo Presti criteria (Sensitivity 62%, Specificity 90%)

SD + SV4 ≥ 2.8 mV(M), 2.3(F)

; SD = deepest S in any lead.

References

1) Hancock EW, Deal BJ, Mirvis DM, Okin P, Kligfield P, Gettes LS, Bailey JJ, Childers R, Gorgels A, Josephson M, Kors JA, Macfarlane P, Mason JW, Pahlm O, Rautaharju PM, Surawicz B, van Herpen G, Wagner GS, Wellens H; American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; American College of Cardiology Foundation; Heart Rhythm Society. AHA/ACCF/HRS recommendations for the standardization and interpretation of the electrocardiogram: part V: electrocardiogram changes associated with cardiac chamber hypertrophy: a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society. Endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol. 2009 Mar 17;53(11):992-1002. doi: 10.1016/j.jacc.2008.12.015. PMID: 19281932.​

2) Peguero JG, Lo Presti S, Perez J, Issa O, Brenes JC, Tolentino A. Electrocardiographic Criteria for the Diagnosis of Left Ventricular Hypertrophy. J Am Coll Cardiol. 2017 Apr 4;69(13):1694-1703. doi: 10.1016/j.jacc.2017.01.037. PMID: 28359515.

©2023 BY Piti Niyomsirivanich, MD. (Personal use)
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