AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram. Part V: Electrocardiogram Changes Associated With Cardiac Chamber Hypertrophy A Scientific Statement From the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society

Journal of the American College of Cardiology

Volumn 53, Issue 11, 2009, Pages 992-1002

  Hancock, E William ^a   Deal, Barbara J ^a   Mirvis, David M ^a   Okin, Peter ^a   Kligfield, Paul ^a   Gettes, Leonard S ^a  

^a NONE

Author keywords

ACCF Expert Consensus Documents; conduction; echocardiography; electrocardiography; electrophysiology; hypertrophy; myocardium

Indexed keywords

AGE DISTRIBUTION; AMPLITUDE MODULATION; CLINICAL ASSESSMENT; DIAGNOSTIC ACCURACY; ELECTRIC POTENTIAL; ELECTROCARDIOGRAM; HEART LEFT BUNDLE BRANCH BLOCK; HEART LEFT VENTRICLE HYPERTROPHY; HEART RIGHT BUNDLE BRANCH BLOCK; HEART VENTRICLE HYPERTROPHY; HUMAN; P WAVE; PRACTICE GUIDELINE; PRIORITY JOURNAL; QRS COMPLEX; RACE; REVIEW; SEX DIFFERENCE; ST SEGMENT; STANDARDIZATION; T WAVE;

AGE FACTORS; CARDIOMEGALY; CHILD; CHILD, PRESCHOOL; ELECTROCARDIOGRAPHY; ELECTRODES; HEART BLOCK; HEART CONDUCTION SYSTEM; HEART DISEASES; HUMANS; IMAGE PROCESSING, COMPUTER-ASSISTED; INFANT; INFANT, NEWBORN; SENSITIVITY AND SPECIFICITY; TERMINOLOGY AS TOPIC;

EID: 61649116221     PISSN: 07351097     EISSN: None     Source Type: Journal    
DOI: 10.1016/j.jacc.2008.12.015     Document Type: Review

References (78)

1. Mathew J., Sleight P., Lonn E., et al. Reduction of cardiovascular risk by regression of electrocardiographic markers of left ventricular hypertrophy by the angiotensin-converting enzyme inhibitor ramipril. Circulation 104 (2001) 1615-1621
2. Okin P.M., Devereux R.B., Jern S., et al. Regression of electrocardiographic left ventricular hypertrophy by losartan versus atenolol: the Losartan Intervention for Endpoint Reduction in Hypertension (LIFE) Study. Circulation 108 (2003) 684-690
3. Devereux R.B., Pini R., Aurigemma G.P., and Roman M.J. Measurement of left ventricular mass: methodology and expertise. J Hypertens 15 (1997) 801-809
4. Einthoven W. Le telecardiogramme. Archives internat de physiol 4 (1906) 132-134 [Translation published in Am Heart J. 1955;49:77-82 and Am Heart J. 1957;53:602]
5. Lewis T. Observations upon ventricular hypertrophy with special reference to preponderance of one or the other chamber. Heart 5 (1914) 367-402
6. Gubner R.S., and Ungerlieder H.E. Electrocardiographic criteria of left ventricular hypertrophy: factors determining the evolution of the electrocardiographic patterns in hypertrophy and bundle branch block. Arch Intern Med 72 (1943) 196-209
7. Sokolow M., and Lyon T.P. The ventricular complex in left ventricular hypertrophy as obtained by unipolar and limb leads. Am Heart J 37 (1949) 161-186
8. Casale P., Devereux R., Kligfield P., et al. Electrocardiographic detection of left ventricular hypertrophy: development and prospective validation of improved criteria. J Am Coll Cardiol 6 (1985) 572-580
9. Romhilt D.W., and Estes E.H. A point score system for the ECG diagnosis of left ventricular hypertrophy. Am Heart J 75 (1968) 752-758
10. Okin P.M., Roman M.J., Devereux R.B., and Kligfield P. Electrocardiographic identification of increased left ventricular mass by simple voltage-duration products. J Am Coll Cardiol 25 (1995) 417-423
11. Okin P.M., Roman M.J., Devereux R.B., and Kligfield P. Time-voltage area of the QRS for the identification of left ventricular hypertrophy. Hypertension 27 (1996) 251-258
12. Schillaci G., Verdecchia P., Borgioni C., et al. Improved electrocardiographic diagnosis of left ventricular hypertrophy. Am J Cardiol 74 (1994) 714-719
13. Norman Jr. J.E., and Levy D. Improved electrocardiographic detection of echocardiographic left ventricular hypertrophy: results of a correlated data base approach. J Am Coll Cardiol 26 (1995) 1022-1029
14. Rautaharju P.M., Manolio T.A., Siscovick D., et al. Utility of new electrocardiographic models for left ventricular mass in older adults: the Cardiovascular Health Study Collaborative Research Group. Hypertension 28 (1996) 8-15
15. MacFarlane P.W., and Lawrie T.D. Comprehensive Electrocardiography: Theory and Practice in Health and Disease (1988), Pergamon Press, Oxford, United Kingdom
16. Okin P.M., Devereux R.B., Jern S., Kjeldsen S.E., et al. Baseline characteristics in relation to electrocardiographic left ventricular hypertrophy in hypertensive patients: the Losartan Intervention for Endpoint Reduction (LIFE) in hypertension study: the Life Study Investigators. Hypertension 36 (2000) 766-773
17. Murphy M.L., Thenabadu P.N., de Soyza N., et al. Sensitivity of electrocardiographic criteria for left ventricular hypertrophy according to type of heart disease. Am J Cardiol 55 (1985) 545-549
18. Simonson E. Differentiation Between Normal and Abnormal in Electrocardiography (1961), Mosby, St. Louis, MO
19. Alfakih K., Walters K., Jones T., et al. New gender-specific partition values for ECG criteria of left ventricular hypertrophy: recalibration against cardiac MRI. Hypertension 44 (2004) 175-179
20. Casale P.N., Devereux R.B., Alonso D.R., et al. Improved sex-specific criteria of left ventricular hypertrophy for clinical and computer interpretation of electrocardiograms: validation with autopsy findings. Circulation 75 (1987) 565-572
21. Rao P.S., Thapar M.K., and Harp R.J. Racial variations in electrocardiograms and vector cardiograms between black and white children and their genesis. J Electrocardiol 17 (1984) 239-252
22. Rautaharju P.M., Zhou S.H., and Calhoun H.P. Ethnic differences in ECG amplitudes in North American white, black and Hispanic men and women: the effect of obesity and age. J Electrocardiol 27 (1994) 20-31
23. Vitelli L.L., Crow R.S., Shahar E., et al. Electrocardiographic findings in a healthy biracial population: Atherosclerosis Risk in Communities (ARIC) Study Investigators. Am J Cardiol 81 (1998) 453-459
24. Nath A., Alpert M.A., Terry B.E., and Kelly D.L. Sensitivity and specificity of electrocardiographic criteria for left and right ventricular hypertrophy in morbid obesity. Am J Cardiol 62 (1988) 126-130
25. Abergel E., Tase M., Menard J., and Chatellier G. Influence of obesity on the diagnostic value of electrocardiographic criteria for detecting left ventricular hypertrophy. Am J Cardiol 77 (1996) 739-744
26. Okin P.M., Jern S., Devereux R.B., et al. Effect of obesity on electrocardiographic left ventricular hypertrophy in hypertensive patients: the Losartan Intervention for Endpoint (LIFE) Reduction in Hypertension Study. Hypertension 35 (2000) 13-18
27. Okin P.M., Roman M.J., Devereux R.B., and Kligfield P. Electrocardiographic identification of left ventricular hypertrophy: test performance in relation to definition of hypertrophy and presence of obesity. J Am Coll Cardiol 27 (1996) 124-131
28. Barnes A.R., and Whitten M.B. Study of T-wave negativity in predominant ventricular strain. Am Heart J 5 (1929) 14-67
29. Kaplan L.G., and Katz L.N. The characteristic electrocardiograms in left ventricular strain with and without axis deviation. Am J Med Sci 201 (1941) 676-693
30. Kannel W.B., Gordon T., Castelli W.P., and Margolis J.R. Electrocardiographic left ventricular hypertrophy and risk of coronary heart disease: the Framingham study. Ann Intern Med 72 (1970) 813-822
31. Okin P.M., Devereux R.B., Nieminen M.S., et al. Electrocardiographic strain pattern and prediction of cardiovascular morbidity and mortality in hypertensive patients. Hypertension 44 (2004) 48-54
32. Gertsch M., Theler A., and Foglia E. Electrocardiographic detection of left ventricular hypertrophy in the presence of left anterior fascicular block. Am J Cardiol 61 (1988) 1098-1101
33. Bozzi G., and Figina A. Left anterior hemiblock and electrocardiographic diagnosis of left ventricular hypertrophy. Adv Cardiol 16 (1976) 495-500
34. Fragola P., Autore C., Magni G., et al. Limitations of the electrocardiographic diagnosis of left ventricular hypertrophy: the influence of left anterior hemiblock and right bundle branch block. Int J Cardiol 34 (1992) 41-48
35. Petersen G.V., and Tikoff G. Left bundle branch block and left ventricular hypertrophy: electrocardiographic-pathologic correlations. Chest 59 (1971) 174-177
36. Havelda C.J., Sohi G.S., Flowers N.C., and Horan L.G. The pathologic correlates of the electrocardiogram: complete left bundle branch block. Circulation 65 (1982) 445-451
37. Fragola P.V., Autore C., Ruscitti G., et al. Electrocardiographic diagnosis of left ventricular hypertrophy in the presence of left bundle branch block: a wasted effort. Int J Cardiol 28 (1990) 215-221
38. Klein R.C., Vera Z., DeMaria A.N., and Mason D.T. Electrocardiographic diagnosis of left ventricular hypertrophy in the presence of left bundle branch block. Am Heart J 108 (1984) 502-506
39. Noble L.M., Humphrey S.B., and Monoghan G.B. Left ventricular hypertrophy in left bundle branch block. J Electrocardiol 17 (1984) 157-160
40. Kafka H., Burggraf G.W., and Milliken J.A. Electrocardiographic diagnosis of left ventricular hypertrophy in the presence of left bundle branch block: an echocardiographic study. Am J Cardiol 55 (2000) 103-106
41. Mehta A., Jain A.C., Mehta M.C., and Billie M. Usefulness of left atrial abnormality for predicting left ventricular hypertrophy in the presence of left bundle branch block. Am J Cardiol 85 (2000) 354-359
42. Haskell R.J., Ginzton L.E., and Laks M.M. Electrocardiographic diagnosis of left ventricular hypertrophy in the presence of left bundle branch block. J Electrocardiol 20 (1987) 227-232
43. Scott R.C. Left bundle branch block: a clinical assessment. Am Heart J 70 (1965) 535-566
44. Holt Jr. J.H., Barnard A.C., and Kramer Jr. J.O. A study of the human heart as a multiple dipole source: IV. Left ventricular hypertrophy in the presence of right bundle branch block. Circulation 56 (1977) 391-394
45. Murphy M.L., Thenabadu P.N., de Soyza N., et al. Left atrial abnormality as an electrocardiographic criterion for the diagnosis of left ventricular hypertrophy in the presence of right bundle branch block. Am J Cardiol 52 (1983) 381-383
46. De Leonardis V., Goldstein S.A., and Lindsay Jr. J. Electrocardiographic diagnosis of left ventricular hypertrophy in the presence of complete right bundle branch block. Am J Cardiol 62 (1988) 590-593
47. Vandenberg B., Sagar K., Paulsen W., and Romhilt D. Electrocardiographic criteria for diagnosis of left ventricular hypertrophy in the presence of complete right bundle branch block. Am J Cardiol 63 (1989) 1080-1084
48. Davignon A., Rautaharju P.M., Poisselle E., et al. Normal ECG standards for infants and children. Pediatr Cardiol 1 (1979) 123-152
49. Macfarlane P.W., Coleman E.N., Pomphrey E.O., et al. Normal limits of the high-fidelity pediatric ECG: preliminary observations. J Electrocardiol 22 Suppl (1989) 162-168
50. Rijnbeek P.R., Witsenburg M., Schrama E., et al. New normal limits for the paediatric electrocardiogram. Eur Heart J 22 (2001) 702-711
51. Butler P.M., Leggett S.I., Howe C.M., et al. Identification of electrocardiographic criteria for diagnosis of right ventricular hypertrophy due to mitral stenosis. Am J Cardiol 57 (1986) 639-643
52. Scott R.C. The electrocardiographic diagnosis of right ventricular hypertrophy in the adult. Heart Bull 16 (1967) 65-67
53. Murphy M., and Hutcheson F. The electrocardiographic diagnosis of right ventricular hypertrophy in chronic obstructive pulmonary disease. Chest 65 (1974) 622-627
54. Murphy M.L., Thenabadu P.N., de Soyza N., et al. Reevaluation of electrocardiographic criteria for left, right, and combined cardiac ventricular hypertrophy. Am J Cardiol 53 (1984) 1140-1147
55. Lehtonen J., Sutinen S., Ikäheimo M., and Pääkkö P. Electrocardiographic criteria for the diagnosis of right ventricular hypertrophy verified at autopsy. Chest 93 (1988) 839-842
56. Selvester R.H., and Rubin H.B. New criteria for the electrocardiographic diagnosis of emphysema and cor pulmonale. Am Heart J 69 (1965) 437-447
57. Nunez B.D., Messerli F.H., Amodeo C., et al. Biventricular hypertrophy in essential hypertension. Am Heart J 114 (1987) 813-818
58. Jain A., Chandna H., Silber E.N., et al. Electrocardiographic patterns of patients with echocardiographically determined biventricular hypertrophy. J Electrocardiol 32 (1999) 269-273
59. Alpert M.A., and Munuswamy K. Electrocardiographic diagnosis of left atrial enlargement. Arch Intern Med 149 (1989) 1161-1165
60. Hazen M.S., Marwick T.H., and Underwood D.A. Diagnostic accuracy of the resting electrocardiogram in detection and estimation of left atrial enlargement: an echocardiographic correlation in 551 patients. Am Heart J 122 (1991) 823-828
61. Josephson M.E., Kastor J.A., and Morganroth J. Electrocardiographic left atrial enlargement: electrophysiologic, echocardiographic and hemodynamic correlates. Am J Cardiol 39 (1977) 967-971
62. Wagner M.L., Lazarra R., Weiss R.M., and Hoffman B.F. Specialized conducting fibers in the interatrial band. Circ Res 18 (1966) 502-518
63. Waldo A.L., Bush Jr. H.L., Gelband H., et al. Effects on the canine P wave of discrete lesions in the specialized atrial tracts. Circ Res 29 (1971) 452-467
64. Reeves W.C., Hallahan W., Schwiter E.J., et al. Two-dimensional echocardiographic assessment of electrocardiographic criteria for right atrial enlargement. Circulation 64 (1981) 387-391
65. Goldberger E. Unipolar Lead Electrocardiography and Vectorcardiography, Including Standard Leads, Augmented Unipolar Extremity Leads and Multiple Unipolar Precordial Leads, and a Section on Cardiac Arrhythmias. 2nd edition (1949), Lea & Febiger, Philadelphia, PA
66. Grant R.P. Clinical Electrocardiography: The Spatial Vector Approach (1957), McGraw-Hill Blakiston Division, New York, NY
67. Holt D.H., and Spodick D.H. The Rv6:Rv5 voltage ratio in left ventricular hypertrophy. Am Heart J 63 (1962) 65-66
68. Manning G.W., and Smiley J.R. QRS-voltage criteria for left ventricular hypertrophy in a normal male population. Circulation 29 (1964) 224-230
69. Mazzoleni A., Wolff R., Wolff L., and Reiner L. Correlation between component cardiac weights and electrocardiographic patterns in 185 cases. Circulation 30 (1964) 808-829
70. McPhie J. Left ventricular hypertrophy: electrocardiographic diagnosis. Australas Ann Med 7 (1958) 317-327
71. Molloy T.J., Okin P.M., Devereux R.B., and Kligfield P. Electrocardiographic detection of left ventricular hypertrophy by the simple QRS voltage-duration product. J Am Coll Cardiol 20 (1992) 1180-1186
72. Romhilt D.W., Bove K.E., Norris R.J., et al. A critical appraisal of the electrocardiographic criteria for the diagnosis of left ventricular hypertrophy. Circulation 40 (1969) 185-195
73. Schack J.A., Rosenman R.H., and Katz L.N. The aV limb leads in the diagnosis of ventricular strain. Am Heart J 40 (1950) 696-705
74. Siegel R.J., and Roberts W.C. Electrocardiographic observations in severe aortic valve stenosis: correlative necropsy study to clinical, hemodynamic, and ECG variables demonstrating relation to 12-lead QRS amplitude to peak systolic transaortic pressure gradient. Am Heart J 103 (1982) 210-221
75. Vandenberg B.F., and Romhilt D.W. Electrocardiographic diagnosis of left ventricular hypertrophy in the presence of bundle branch block. Am Heart J 122 (1991) 818-822
76. Wilson F.N., Johnston F.D., Rosenbaum F.F., et al. The precordial electrocardiogram. Am Heart J 27 (1944) 19-85
77. Wolff L. Electrocardiography: Fundamentals and Clinical Application. 2nd edition (1956), WB Saunders, Philadelphia, PA
78. Myers G.B., Klein H.A., and Stofer B.E. Electrocardiographic diagnosis of right ventricular hypertrophy. Am Heart J 35 (1948) 1-40