Electrocardiographic signs commonly related to COPD
| Emphysema | P-wave axis24 |
| Right-atrium enlargement2 | P-amplitude in II, III or aVF ≥2.5 mm1 2 |
| P-amplitude in V1 ≥1.5 mm2 | |
| Scott et al11: RVH | R in V1 ≥7 mm |
| R/S in V1 >1 | |
| VAT in V1 >35 ms | |
| Sokolow-Lyon: RVH | R in V1 + S in V5 or V6 >10.5 mm16 |
| Clockwise rotation | R/S ratio in V5 ≤11 |
| Low voltage limb leads | QRS (R+S) <5 mm in I, II, aVF, III (all)*1 |
| Low voltage precordial leads | QRS <10 mV in V1–V6 (all)* |
| S1S2S3 pattern | Dominant S in I, II, III (all)1 |
| QS complex | Lead III |
| Right-axis deviation: | >90°1 |
| Left-axis deviation: | <-30° to −90°1 2 |
| Elevated resting heart rate | HR >80 beats/min* |
*Minnesota Code20
HR, heart rate; RVH, right ventricular hypertrophy; VAT, ventricular activation time.