Diagnostic value of R wave in aVL lead in left ventricular hypertrophy

Introduction: left ventricular hypertrophy (LVH) is defined as the increase in the thickness of the wall or the interventricular septal portion (or both). This entity represents an important risk factor that is related to the increase in mortality. Its diagnosis is based on voltage criteria that become visible on the is based on voltage criteria that become visible on the electrocardiogram, such as that the R-wave voltage criterion in lead aVL (RaVL). Objective: to evaluate the diagnostic utility of the R-wave voltage criterion in lead aVL (RaVL) for left ventricular hypertrophy. Methods: an observational, analytical and cross-sectional study was conducted, where 127 patients were studied. Clinical and electrocardiographic variables were studied. Results: left ventricular hypertrophy was identified by echocardiography in 69 % of patients. The voltage criterion of the R-wave in lead aVL (RaVL) had a low sensitivity (14,9 %), high specificity (92,5 %) and high positive predictive value (81,3%). The Odds ratio of the R-wave in lead aVL (RaVL) for concentric left ventricular hypertrophy was 0,85 while for the severe one it was 6,13. Conclusions: the voltage criterion of the R-wave voltage in lead aVL (RaVL) was more useful to confirm the cases that in reality present left ventricular hypertrophy and not to deny such existence, but not to discriminate between both types of left ventricular hypertrophy. This criterion is very useful to detect severe forms of this entity.