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LVH Sokolow-Lyon Index Calculator

Calculate the Sokolow-Lyon voltage criterion for electrocardiographic evidence of left ventricular hypertrophy (LVH).

1

Enter ECG Measurements

mm
S-wave amplitude in V1.
mm
R-wave amplitude in V5.
mm
R-wave amplitude in V6.

Sokolow-Lyon Voltage Criterion: Clinical Context

The Sokolow-Lyon criterion is a conventional electrocardiographic voltage criterion used to identify ECG evidence of left ventricular hypertrophy (LVH). It is based on the QRS voltage measured in the precordial leads.

Formula:
Sokolow-Lyon voltage criterion = S wave in V1 + the tallest R wave in V5 or V6

The conventional adult criterion is > 35 mm (3.5 mV). The R-wave amplitude is taken from whichever is taller between leads V5 and V6.

Clinical interpretation

A value above 35 mm meets the conventional Sokolow-Lyon voltage criterion for ECG evidence of LVH. However, this finding does not by itself establish anatomical LVH or increased left ventricular mass.

The Sokolow-Lyon criterion has relatively limited sensitivity for detecting increased left ventricular mass. Therefore, a value at or below 35 mm does not exclude LVH.

ECG voltage can be affected by factors including body habitus, age, chest configuration, and other cardiac or cardiopulmonary conditions. The result should therefore be interpreted in conjunction with the complete ECG and the patient's clinical context.

Clinical note: The Sokolow-Lyon criterion is an ECG voltage criterion and should not be used as a standalone method to exclude anatomical LVH. When assessment of left ventricular structure or mass is clinically indicated, echocardiography or another appropriate cardiac imaging modality may be considered.

References

  1. Sokolow M, Lyon TP. The ventricular complex in left ventricular hypertrophy as obtained by unipolar precordial and limb leads. American Heart Journal. 1949;37(2):161-186.
  2. Casale PN, Devereux RB, Alonso DR, Campo E, Kligfield P. Improved sex-specific criteria of left ventricular hypertrophy for clinical and computer interpretation of electrocardiograms: validation with autopsy findings. Circulation. 1987;75(2):364-370. PubMed
  3. Pewsner D, Jüni P, Egger M, Battaglia M, Sundström J, Bachmann LM. Accuracy of electrocardiography in diagnosis of left ventricular hypertrophy in arterial hypertension: systematic review. BMJ. 2007;335:711.
  4. Schirmer H, Lunde P, Rasmussen K. Prevalence of left ventricular hypertrophy in a general population: the Tromsø Study. European Heart Journal. 1999;20(6):429-438.
  5. Molloy TJ, Okin PM, Devereux RB, Kligfield P. Electrocardiographic detection of left ventricular hypertrophy by the simple QRS voltage-duration product. Journal of the American College of Cardiology. 1992;20(5):1180-1186.

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Appcardio may contain errors. Always verify the calculation and its accuracy before clinical use.