Description

Klein et al developed electrocardiographic criteria for the diagnosis of left ventricular hypertrophy in the presence of left bundle branch block.


 

Recommended Criteria

 

(peak height of S wave in V2) + (peak height of R wave in V6) >= 4.5 mm

• sensitivity 86%, specificity 100%, predictive value 100%

 

QRS duration > 160 msec with left atrial enlargement is:

(1) supportive of the diagnosis of LVH, with specificity of 96% when SV2 + RV6 <= 4.4 mm

(2) present in only a small percentage of patients

 

Other Criteria Evaluated (Table III, page 505)

 

(peak height of S wave in V1) + (peak height of R wave in V6) >= 3.5 mm

• sensitivity 74%, specificity 90%, predictive value 88%

 

QRS duration > 140 seconds

• sensitivity 71%, specificity 83%, predictive value 83%

 

left atrial enlargement present:

• sensitivity 86%, specificity 91%, predictive value 90%

 


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