P wave |
Left atrial enlargement: negative portion of the P wave in lead V1 ≥0.1 mV in depth and ≥0.04 s in duration |
Right atrial enlargement: peaked P wave in leads II and III or V1 ≥0.25 mV in amplitude |
QRS complex |
Frontal plane axis deviation: right ≥+120° or left –30° to –90° |
Increased voltage: amplitude of R or S wave in a standard lead ≥2 mV, S wave in lead V1 or V2 ≥3 mV, or R wave in lead V5 or V6 ≥3 mV |
Abnormal Q waves ≥0.04 s in duration or ≥25% of the height of the ensuing R wave or QS pattern in two or more leads |
Right or left bundle-branch block with QRS duration ≥0.12 s |
R or R′ wave in lead V1 ≥0.5 mV in amplitude and R/S ratio ≥1 |
ST segment, T waves and QT interval |
ST-segment depression or T-wave flattening or inversion in two or more leads |
Prolongation of heart rate-corrected QT interval >0.44 s in males and >0.46 s in females |
Rhythm and conduction abnormalities |
Premature ventricular beats or more severe ventricular arrhythmias |
Supraventricular tachycardias, atrial flutter or atrial fibrillation |
Short PR interval (<0.12 s) with or without “δ” wave |
Sinus bradycardia with resting heart rate ≤40 beats/min |
First- (PR >0.21 s), second- or third-degree atrioventricular block |