Electrocardiographic diagnosis of left ventricular hypertrophy in the presence of left bundle branch block: An echocardiographic study

Electrocardiographic diagnosis of the left ventricular hypertrophy in patients with left bundle branch block: Is it necessary to verify old criteria?

“…Important value of the presence of the left atrial enlargement in LVH detection was also reported in our study. Kafka et al [14] in echocardiography/ECG study reported comparable results in 100 patients with LBBB. In our study the highest accuracy for LVH detection in LBBB ECG was achieved when the combination of the amplitude of S waves in V2--V3 and R waves in aVL or V5, V6.…”

“…Havelda et al [13] in their study from 1982 observed higher accuracy of the ECG for LVH detection in patients with more pronounced LVH. Opposite observation reported Kafka et al [14] in 1985 in echocardiography/ECG study of 100 patients with LBBB. The sensitivity and specificity was lower in cases with LVMI > 215 g/m 2 than in those with LVMI > 115 g/m 2 .…”

“…The highest values (area under curve > 0.8) were noted for parameters that included S wave amplitude: S in V2, V3 i.e. RaVL+SV3, SV2+SV3, autopsy or echocardiographic study [7][8][9][10][11][12][13][14]. The most frequently cited ECG criterion for LVH in patients with LBBB (S in V2+RV6 > 45 mm) was reported with maximal 86% sensitivity and 100% specificity [15].…”

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

“…Studies of the electrocardiographic diagnosis of LVH in the presence of complete left bundle-branch block (LBBB) have yielded conflicting results (35)(36)(37)(38)(39)(40)(41). Some have concluded that the diagnosis should not be attempted in this setting (35)(36)(37), whereas others believe that the diagnosis can be made (38 -41).…”

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

“…[32][33][34] Left Bundle-Branch Block Studies of the electrocardiographic diagnosis of LVH in the presence of complete left bundle-branch block (LBBB) have yielded conflicting results. [35][36][37][38][39][40][41] Some have concluded that the diagnosis should not be attempted in this setting, [35][36][37] whereas others believe that the diagnosis can be made. 38 -41 Estimations of specificity are affected by the relatively high prevalence of anatomic LVH in patients with LBBB, especially in autopsy series, where it may be 90% or more.…”