Assessment of selected ECG voltage criteria for abnormality in eccentric and concentric left ventricular hypertrophy

The effect of left ventricular volume (LVV) in relation to the left ventricular mass (LVM) was studied on the voltage electrocardiography (ECG) criteria of left ventricular hypertrophy (LVH). For this purpose, the sensitivity of numerous voltage criteria were assessed in patients with documented echocardiographic (echo) LVH with or without left ventricular dilatation. The ECG criteria that combined voltages in two leads were more sensitive than when a single voltage criterion was utilized. There was no characteristic pattern of increased voltages to differentiate between eccentric and concentric subtypes of LVH. However, the Cornell criteria were less affected by the LV geometry for detecting LVH with or without LV dilatation. This is probably due to the fact that they utilize the voltages in a precordial and a limb lead.