Abstract
The ECG in 100 patients with proven isolated tetralogy of Fallot and no surgery was analyzed. 96% had signs of right ventricular hypertrophy. No patient had left ventricular hypertrophy or a QRS axis in the left upper quandrant in the frontal plane. In order of decreasing frequency, the signs of right ventricular hypertrophy were: abnormal R/S ratio in V1, right axis deviation in the frontal plane, abnormally low R/S ratio in V6, abnormally deep S waves in V6, abnormal R wave in V1, abnormal T wave in the right precordium and q waves in V1. Slurring, notching or rsR′ complexes in V1 were frequently found in tetralogies, but not more so than in pulmonic stenosis with intact septum. There is no correlation between the hemodynamic severity and the electrocardigraphic criteria for right ventricular hypertrophy. The electrocardiogram in patients with tetralogies changed very little as time elapsed. A lack of increase or a decrease in left ventricular precordial potentials was seen most frequently.
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