Reply: Electrocardiographic Criteria for Diagnosing Left Ventricular Hypertrophy and Predicting Mortality in Patients With Aortic Stenosis

[...]they have shown the outstanding relationship between electrocardiographic (ECG) criteria and all-cause mortality in patients with aortic stenosis, which further emphasizes the importance of having an accurate ECG-LVH criteria when evaluating the cardiac patient. The 2009 American Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Recommendations for the Standardization and Interpretation of the Electrocardiogram propose that LVH criteria that include the R-wave in limb leads I or aVL (e.g., Cornell voltage criteria) are unreliable in the presence of LAFB (2). [...]a more current investigation by Ravi and colleagues concluded that there was no difference in overall accuracy between aVL- and non-aVL-based criteria for diagnosing LVH in the presence of LAFB (3). [...]LAFB is usually considered a diagnosis of exclusion after LVH, left bundle branch block, and inferior wall Q-wave myocardial infarction have been ruled out.