Abstract
Objective: We sought to test the hypothesis that the total QRS voltage without either set of the limb leads (I, II, III) or (R, L, F) may be a better indicator of LVH as compared to the total QRS voltage. Background: The total 12 lead QRS voltage has been a validated electrocardiographic criterion for left ventricular hypertrophy (LVH), with an upper limit of175 mm. However, there is some redundancy in this measurement as the output of the limb leads is repeated because leads I, II, III, and R, L, F use the same three electrodes. Methods: 43 unselected, consecutive echocardiograms were examined for evidence of LVH by wall thickness. Electrocardiogram (ECG) of these patients within a week of the echocardiogram were then examined for the total 12 leads QRS voltage, minus I, II, III and total minus R, L, F voltages. ECG findings were then compared with corresponding echocardiographic dimensions. Results: A total QRS voltage of123 mmon ECG yielded a sensitivity of 73% and specificity of 67% for diagnosing LVH with 95% CI = 0.59 - 0.89, p = 0.007. Total minus (R, L and F) value of110 mmon ECG appears to give the best sensitivity (73%), specificity (72%), and accuracy (64% negative predictive value and 82% positive predictive value) for LVH. Conclusion: It appears that total QRS voltage minus either set of the limb leads, especially the total minus R, L and F is a better criterion, with110 mmbeing the best specific, sensitive and accurate index for diagnosing LVH.
Highlights
There are many electrocardiographic (ECG) criteria for diagnosing left ventricular hypertrophy (LVH), most voltage based
We sought to test the hypothesis that the total QRS voltage without either set of the limb leads (I, II, III) or (R, L, F) may be a better indicator of LVH as compared to the total QRS voltage
43 unselected, consecutive echocardiograms were examined for evidence of LVH by wall thickness
Summary
There are many electrocardiographic (ECG) criteria for diagnosing left ventricular hypertrophy (LVH), most voltage based. The total 12 lead QRS voltage has been validated as a criterion in different disease states [1,2,3,4,5,6,7,8], most of these have been necropsy studies. The normal upper limit for total QRS amplitude of 175 mm was first determined by Roberts and Day [3] and later validated by Odom et al [4] in their study of men free of cardiopulmonary disease. Their study established that a total QRS voltage of 127 ± 29 mm as an average range on autopsied men free of cardiopulmonary disease. Rodriguez established that a total 12-lead QRS voltage >120 mm is a good ECG criterion for LVH among patients with essential hypertension [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
