Electrocardiographic Features

Diagnostic criteria

Right axis deviation of +110° or more.

Dominant R wave in V1 (> 7mm tall or R/S ratio > 1).

Dominant S wave in V5 or V6 (> 7mm deep or R/S ratio < 1).

QRS duration < 120ms (i.e. changes not due to RBBB).

Supporting criteria

Right atrial enlargement (P pulmonale).

Right ventricular strain pattern = ST depression / T wave inversion in the right precordial (V1-4) and inferior (II, III, aVF) leads.

S1 S2 S3 pattern = far right axis deviation with dominant S waves in leads I, II and III.

Deep S waves in the lateral leads (I, aVL, V5-V6).

Other abnormalities caused by RVH

Right bundle branch block (complete or incomplete).

NB. There are no universally accept

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