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J Electrocardiol. 2017 Jan - Feb;50(1):11-15. doi: 10.1016/j.jelectrocard.2016.11.003. Epub 2016 Nov 10.

The 4th Report of the Working Group on ECG diagnosis of Left Ventricular Hypertrophy.

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International Laser Center, Bratislava, Slovak Republic; Institute of Pathophysiology, Medical School, Comenius University, Bratislava, Slovak Republic. Electronic address:
Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA.
Division of Cardiology, Duke University School of Medicine, Durham, USA.
Department of Clinical Physiology, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Epidemiological Cardiology Research Center (EPICARE), Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA.
Department of Internal Medicine, Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Copenhagen University Hospital, Rigshospitalet, The Heart Center, Department of Cardiology, Denmark.
Department of Clinical Physiology, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden; Nicollier-Schlegel SARL, Trélex, Switzerland.


The 4th Report provides a brief review of publications focused on the electrocardiographic diagnosis of left ventricular hypertrophy published during the period of 2010 to 2016 by the members of the Working Group on ECG diagnosis of Left Ventricular Hypertrophy. The Working Group recommended that ECG research and clinical attention be redirected from the estimation of LVM to the identification of electrical remodeling, to better understanding the sequence of events connecting electrical remodeling to outcomes. The need for a re-definition of terms and for a new paradigm is also stressed.


Electrical remodeling; Electrocardiogram; Left ventricular hypertrophy; New paradigm; Working group

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