Criterion | Value | Reference
--- | --- | ---
Tall R V1 | >6 mm | Myers
Increased R:S ratio V1 | >1.0 | Myers
Deep S V5 | >10 mm | Myers
Deep S V6 | >3 mm | Myers
Tall R aVR | >4 mm | Sokolow
Small S V1 | <2 mm | Myers
Small R V5,6 | <3 mm | Myers
Reduced R:S ratio V5 | <0.75 | Myers
Reduced R:S ratio V6 | <0.4 | Myers
Reduced R:S V5 to R:S V1 | <0.04 | Sokolow
(R I+S III)-(S I+R III) | <15 mm | Lewis
Max R V1,2+max S I, aVL-S V1 | >6 mm | Butler
R V1+S V5,6 | >10.5 mm | Sokolow
R peak V1 (QRS duration <0.12 sec) | >0.035 sec | Myers
QR V1 | Present | Myers
Supporting Criteria |  |
RSR V1 (QRS duration >0.12 sec) | Present |
S>R in I, II, III | Present |
S I and Q III | Present |
R:S V1>R:S V3,4 | Present |
Negative T-wave V1 through V3 | Present |
P II amplitude | >2.5 mm |

Amplitudes are given in millimeters, where 1 mm=0.1 mV.

## References

- Table from: Hancock EW, Deal BJ, Mirvis DM, et al. AHA/ACC/HRS recommendations for the standardization and interpretation of the electrocardiogram. Part V: Electrocardiogram changes associated with cardiac chamber hypertrophy. J Am Coll Cardiol 2009;53:992. http://content.onlinejacc.org/article.aspx?articleid=1139534
- Myers GB, Klein HA, Stofer BE. Electrocardiographic diagnosis of right ventricular hypertrophy. Am Heart J 1948;35:1.
- Sokolow M, Lyon TP. The ventricular complex in left ventricular hypertrophy as obtained by unipolar and limb leads. Am Heart J 1949;37:161.
- Lewis T. Observations upon ventricular hypertrophy with special reference to preponderance of one or the other chamber. Heart 1914;5:367.
- Butler PM, Leggett SI, Howe CM. Identification of electrocardiographic criteria for diagnosis of right ventricular hypertrophy due to mitral stenosis. Am J Cardiol 1986;57:639.