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Table 5-1 - Diagnostic Criteria for Common ECG Abnormalities

Abnormality Diagnostic Criteria
Left atrial enlargement P wave duration in lead II ≥0.12 sec OR

P wave in V1 ≥1 mV deep and ≥O.04sec long
Right atrial enlargement P wave in V1 >1.5mV in amplitude OR

P wave in II >2.5 mV in amplitude
Left ventricular hypertrophy S wave in V1 + the R wave in V5 or V6 >35mV OR

S wave in V2 + the R wave in V5 or V6 >45mV OR

R wave in V5 >26mV OR

R wave in lead aVL >II mV OR

R wave in lead I >14mV
Right ventricular hypertrophy R/S ratio in V1 >1 OR

R wave in V1 + the S wave in V5 or V6 ≥II mV OR

R wave in V1 >7mV OR

R/S ratio in V5 or V6 ≤I
Left axis deviation Axis -30° to -105°

Right axis deviation Axis >+100
Pathologic Q wave Duration >0:0.04 sec AND

Amplitude > 1/3 the height of the R wave
Peaked T wave T wave amplitude >6 mV in limb leads OR

T wave amplitude > 10mV in precordial leads
Left bundle branch block QRS duration ≥0:0.12 sec AND

Broad monophasic R wave in leads I, V5, V6
Right bundle branch block QRS duration ≥0:0.12 sec AND

rsR pattern in V1 AND

Wide S wave in V5 , V6 , and lead I
Left anterior fascicular block QRS axis -45° to -90° AND

qR complex in leads I, aVL AND

rS complex in leads III, aVF AND

QRS duration ≤0.10 sec
Left posterior fascicular block QRS axis +100° to +180° AND

Deep S wave in lead I, Q wave in lead III AND

QRS duration ≤ O.10 sec