Electrocardiographic diagnosis of left ventricular hypertrophy in the presence of left bundle branch block: a wasted effort

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

“…Studies of the electrocardiographic diagnosis of LVH in the presence of complete left bundle-branch block (LBBB) have yielded conflicting results (35)(36)(37)(38)(39)(40)(41). Some have concluded that the diagnosis should not be attempted in this setting (35)(36)(37), whereas others believe that the diagnosis can be made (38 -41).…”

“…Some have concluded that the diagnosis should not be attempted in this setting (35)(36)(37), whereas others believe that the diagnosis can be made (38 -41). Estimations of specificity are affected by the relatively high prevalence of anatomic LVH in patients with LBBB, especially in autopsy series, where it may be 90% or more.…”

AHA/ACCF/HRS Recommendations for the Standardization and Interpretation of the Electrocardiogram

“…[32][33][34] Left Bundle-Branch Block Studies of the electrocardiographic diagnosis of LVH in the presence of complete left bundle-branch block (LBBB) have yielded conflicting results. [35][36][37][38][39][40][41] Some have concluded that the diagnosis should not be attempted in this setting, [35][36][37] whereas others believe that the diagnosis can be made. 38 -41 Estimations of specificity are affected by the relatively high prevalence of anatomic LVH in patients with LBBB, especially in autopsy series, where it may be 90% or more.…”

Computer simulation of ECG manifestations of left ventricular electrical remodeling

“…The results are conflicting. [31][32][33][34][35][36] Combining "true" LBBB and slowed conduction velocity, we found in our simulations a decrease in the spatial QRS vector magnitude as compared to either true LBBB or slowed conduction velocity alone. 8 Similar results, that is, a reduced QRS amplitude, were found when the LBBB was combined with reduced intercellular coupling.…”