Electrocardiographic Diagnosis of Ventricular Hypertrophy in the Presence of Right Bundle-Branch Block

Forty-nine autopsied cases of complete and incomplete right bundle-branch block were studied with correlation of the electrocardiographic and anatomic diagnosis of ventricular hypertrophy. Twenty-six (53 per cent) of the cases showed anatomic evidence of right ventricular hypertrophy. The cases were studied for right ventricular hypertrophy according to the criteria of Barker and Valencia and of Milnor. Milnor's criteria resulted in frequent overdiagnosis while those that met Barker and Valencia's criteria usually but not invariably showed anatomic right ventricular hypertrophy. The electrocardiographic diagnosis of left ventricular hypertrophy was masked by the bundle-branch block in anatomically proved cases.