Abstract
An RSR′ pattern in Lead V 1 (with R′ the dominant positive deflection) was found in 108 of 539 patients (20 per cent) with valvular pulmonic stenosis admitted to a national co-operative study of congenital heart defects. On the average, patients with an RSR′ pattern showed lower right ventricular-to-pulmonary artery pressure gradients (mean = 55 mm. Hg) than patients with a QR, R, or RS pattern (mean = 70 mm. Hg). Moreover, an R′-wave of a given voltage was associated with generally lower right ventricular systolic pressures and gradients than an R-wave of equal amplitude. Quantitatively, these data suggest that in patients with an RSR′ complex in Lead V 1, the R′ voltage has the same severity implication as a “pure R” of magnitude (0.5) R′ + 2 mm.
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