Precordial Lead Patterns in Right Ventricular Hypertension

Abstract

The right precordial lead patterns in 80 patients with right ventricular hypertension were studied. The importance of these leads and of ab-normal right axis deviation in the diagnosis of right ventricular hypertro-phy is again confirmed. These criteria failed however in 20% of cases. No correlation was shown between R-voltage and ventricular pressure. Time relationships between different deflections were determined by synchronously recorded intracavity and right or left precordial elec-trocardiograms. The incidence of the various QRS patterns revealed that no typical pattern can be attributed to systolic overloading of the right ventricle. The mechanisms causing the different patterns are discussed and the relevant literature reviewed. It is concluded that rsR'' and qR patterns in right precordial leads are essentially similar and represent hypertorphy of the outflow tract of the right ventricle; while the large R wave is produced by activation of the hypertorphied free wall of the right ventricle.