Poor R-wave progression is an electrocardiographic finding that occurs when the R wave fails to grow progressively from V1 to V4.

ECG Criteria

  • r wave in V3 < 3 mm
  • r wave in V2 < r wave in V3

ECG in Poor R-Wave Progression

Electrocardiogram showing poor R-wave progression

Poor R-wave progression. In this example, the R-wave transition occurs only in lead V5. Note that the r wave in V3 is smaller than 3 mm.

Further Reading

References

  1. de Alencar JN, Amorim EF, Scheffer MK, Felicioni SP, et al. Poor evidence for poor R wave progression in coronary disease: A scoping review. J Electrocardiol. 2024;84(500):145–50.
  2. Zema MJ. ECG Poor R-Wave Progression. Arch Intern Med. 1982;142(6):1145.
  3. Gami AS, Holly TA, Rosenthal JE. Electrocardiographic poor R-wave progression: Analysis of multiple criteria reveals little usefulness. Am Heart J. 2004;148(1):80–5.