Left Ventricular Hypertrophy

Last Updated on August 19, 2026

Diagnostic criteria

Sokolov-Lyon criteria

• S wave depth in V1 + tallest R wave height in V5-V6 > 35 mm

Voltage criteria

Limb Leads
R wave in lead I + S wave in lead III > 25 mm
R wave in aVL > 11 mm
R wave in aVF > 20 mm
S wave in aVR > 14 mm

Precordial Leads
R wave in V4, V5 or V6 > 26 mm
R wave in V5 or V6 plus S wave in V1 > 35 mm
Largest R wave plus largest S wave in precordial leads > 45 mm

Further Reading / Reference

1. https://litfl.com/left-ventricular-hypertrophy-lvh-ecg-library/